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1989, 06-07 Permit App: 89001638 Plumbing Fixtures PLUMBING PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: , w`cv ,. ' CITY/STATE/ZIP: j JCN�. NV Va"k PARCEL NUMBER: OWNER: (' e 'iPHONE NUMBER: MAILING ADDRESS: (Street) (city/State) (Zip) CONTRACTOR: '<'..0 LICENSE NUMBER: kt V C(\Pt PHONE NUMBER: MAILING ADDRESS: �J -��`©L�. k.•=0,;E )k CCS{))` (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 i 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 = 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 = SUBTOTAL $ PLUS: PROCESSING FEE + $ 25. 00 1 EQUALS: TOTAL PERMIT) NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE 1 = $ '/ cam SIGNATURE Spokane County Department of Building_ and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675