1995, 08-08 Permit App: 95006074 Dishwasher ,---.3 - 406
PLUMBING PERMIT APPLICATION
FOJECTADDRESS: 45/t, Ai 44)0ce%'&yt- nSeu Rue, LJ4 ?42'—l/6
OWNER: ( '- .1.."/- l .5 `-C)LA PHONE:DAYTIME CONTACT 324-(Gt)Y�
MAILING ADDRESS: -4>/L, lt)ood/k (.l-tc S cJAGILL'- ( SLI A ?92-1 Li
(street) V (city/state) (zip)
CONTRACTOR:
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CONTRACTOR: (.} S LICENSE: ✓ [— A }..t..,R' L 3.. I aN
,� q ^ PHONE:
MAILING ADDRESS: /t%Y ft 1 Ctid YL [O A I (
(street) (city/state) (zip)
YLUMDttvlr PIA'UKLJ R Of wen t..VbI
DESCRIPTION I DETAIL UNITS tan /UNIT swab AMOUNT
no TOILETS WATER CLOSETS,BIDETS X S6 = $
BO;URINALS - x $6 = $
BO! TUBS BATH.JACUZZI.SPA,GARDEN X $6 = $
BDSHOWERS(per trap) BASE.STALL ON-SITE BUILD x $6 = $
8 SINKS IAVS/BASINS.BAR.FLOOR KITCHEN, X $6 = $
LAUNDRY,UTILITY,JANITOR.PHOTO.
% X-RAY,FOOD(PREP/CULINARY/MEAT)
BO DISHWASHER - I x $6 = $ (e
)I(I CLOTHES WASHER - x $6 = $
GARBAGE DISPOSAL/GRINDER - x $6 = $
$I'V WATER SOFTENER • x $6 = $
`BI:.ELECTRIC HOT WATER TANKS (NOTE: if pa water tank..ec ect.nial) x $6 = $
BI''.FLOOR DRAINS AREA.CASE.COIL TRENCH.CONDENSATE X $6 = $
B1':'.ROOF DRAINS/OVERFLOW DRAIN - X $6 = $
SE FOUNTAINS,DRINKING - x $6 = $
IQ WATER PIPING/DRAIN-WASTE-VE INSTALLATION.ALTERATION.REPAIR. x $6 = $
PLUMBING REVERSALS REVERSALS
in SEWAGE EJECTORS GRINDER.SUMP PUMP x $6 = S
#f WATER USING DEVICES ICE AND/OR COFFEE MAKER, x $6 = $
',/ HOSE BIB,STEAMER,PROOFER.
CARBONATOR.SWAMP COOLERS
BI CROSS-CONNECTION DEVICES VACUUM BREAKER.CHECK VALVE. x $6 = $
AND RP.B.P.D.FOR VATS.SUMPS.
l TANKS,BOILERS,@ SPRINKLER SYSTEMS
etINTERCEPTORS GREASE TRAP,SAND TRAP. x $6 = $
CHEMICAL HOLDING TANK
B2:-MEDICAL GAS(per outlet/bottle stati NiTRous,oxYGEN x $6 = $
IB2' MISCELLANEOUS FIXTURES x $6 = $
NOTE: MINIMUM PERMIT FEE IS $35.00 Subtotal
(/� /n7 PLUS: PROCESSING FE $25.00
SIGNATURE: Ci(..n_ 4, e TOTAL PERMIT FEE DU $ 3 J
PL'.EASEMAKE C 1ECKSSAYABLE TO:
(aK iia.
Spokane County Department of Building&Planning SPOItANECOUNTY�IT CENTER':''..
1026 W.Broadway Avenue•Spokane,WA 99260 -.>.3" r : __..
Tel. No.(509)456-3675•Fax No. (509)324-3198•TOD No. (509)324-3166
Spokane County does not discriminate on the basis of disability in the admission to,or treatment or employment in,its programs or activities.