1990, 05-07 Permit App: 90001929 Plumbing Fixtures PLUMBING PERF$f'APPLICATION FORM
7 Informtiot Worksheet
JOB STREET ADDRESS: 6. //466k,7
CITY/STATE/ZIP: . ',Q7,/ ; ieAc 4 PARCEL NUMBER:
OWNER: LE-4.A.6 / /LGE. ' PHONE NUMBER: 0,%23-
MAILING
,%23-MAILING ADDRESS: c.-509//9g-
(Street) (City/State) (Zip)
CONTRACTOR: y: X1Kg_ LICENSE NUMBER: U -4yP , iS
4
PHONE NUMBER: 924
MAILING ADDRESS: 6 /1/11//4/ 42/9//V e/9"vE a2,9. 94& 0_
(Street) (City/State) (Zip)
PLUMBING WORKSHEET/FEE SCHEDULE
NUMBER OF X EACH
DESCRIPTION FIXTURES FIXTURE = AMOUNT
TOILETS / x $6.00 = (O.
SINKS / x 6.00 = fa.
SHOWERS 1 x 6.00 = 49 .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
ROOF DRAINS x 6.00 =
LAWN SPRINKLER x 6.00 =
SEWAGE EJECTOR -S 'P,P At_ x 6.00 = (p. CX)
WATER SOFTENER x 6.00
URINAL x 6.00 =
DRINKING FOUNTAIN x 6.00 =
i
oo
SUBTOTAL $ Z
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT
NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE = $ 99.40
i l 1
SIGNATUR /'// 470
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675