HomeMy WebLinkAbout1992, 04-29 Permit App: 92002908 Lawn Sprinkler PLUMBING PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: e S Z CJ EJ/es ley
CITY/STATE/ZIP: SpOk*t (-JA PARCEL NUMBER:
OWNER:5 1 E y PHONE NUMBER: 9R- �- +0
MAILING ADDRESS:
,��L (Street) (City/State) (Zip)
CONTRACTOR: /h4. l'3 ` Pi rt. LICENSE NUMBER: J -(,a {0/12 " � 4
PHONE NUMBER: .3 e cf cif/()
MAILING ADDRESS: /3/7 /1/4). IesrJr=T61,v .SpSk--4
(Street) (City/State) (Zip)
PLUMBING WORKSHEET/FEE SCHEDULE
NUMBER OF X EACH
DESCRIPTION FIXTURES FIXTURE = AMOUNT
TOILETS x $6. 00 =
SINKS x 6.00 =
SHOWERS x 6.00 =
BATH TUBS x 6. 00 =
KITCHEN SINKS x 6.00 =
DISH WASHERS x 6. 00 =
GARBAGE DISPOSAL x 6.00
CLOTHES WASHER x 6.00 =
UTILITY SINKS x 6.00 =
ELECTRIC WATER HEATERS x 6. 00 =
FLOOR DRAINS x 6. 00 =
FLOOR SINKS x 6.00 =
BAR SINKS x 6. 00 =1
ROOF DRAINS x 6. 00 =
LAWN SPRINKLER x 6. 00 =
SEWAGE EJECTOR x 6.00 =
WATER SOFTENER x 6. 00 =
URINAL x 6.00 =
DRINKING FOUNTAIN x 6. 00 =
C Of L�/IV SUBTOTAL $
PLUS: PROCESSING FEE + $ 25.00
1
EQUALS: TOTALPERMIT!
NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE $ Jr ° J-
1
SIGNATURE
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675.