1994, 03-08 Permit App: 94001800 Plumbing Fixtures PLUMBING PERMIT APPLICATION q-q- I no
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PROJECT ADDRESS: //X X, q
OWNER: ,UO,f/././41. �/791-)7 e,eSUAJ PHONE: t2,2 7-7713
MAILING ADDRESS: 99i5" ,fh S9o,e/g-.7& /12,'' 6
(street) (city/state) (zip)
CONTRACTOR: -Sw Cc Z U$' 4m e /1l 11./4/774/4A/C e Seye,//C e LICENSE: S& e e Z A/me 7 7 D G
PHONE: T-S/?-2 'Y-5
MAILING ADDRESS: GOA f _5-�7-7-Pz.) Q� 69.�e( w/g t' oa.c/
(street) (city/state) (zip)
PLUMBING FIXTURES #OF MULTI— COST
DESCRIPTION I DETAIL UNITS PUEDBY /UNIT EQUALS AMOUNT
E02 TOILETS WATER CLOSETS,BIDETS x $6 = $
BG3 URINALS - x $6 = $
BD4 TUBS BATH,JACUZZI,SPA,GARDEN X $6 = $
B05 SHOWERS(per trap) BASE,STALL,ON—SITE BUILD x $6 = $
B $INKS LAVSBASINS,BAR,FLOOR,KITCHEN, x $6 = $
LAUNDRY,UTILITY,JANITOR,PHOTO, 2_
:,:::::.:::::::: X—RAY,FOOD(PREP/CULINARY/MEAT)
B07 DISHWASHER - x $6 = $
BUS CLOTHES WASHER - x $6 = $
B.00.GARBAGE DISPOSAL/GRINDER - x $6 = $
WO WATER SOFTENER - x $6 = $
8:11 ELECTRIC HOT WATER TANKS (NOTE if gas water tank,see mechanical) x $6 = $
812 FLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE x $6 = $
133 ROOF DRAINS/OVERFLOW DRAINS(ea.) - x $6 = $
B:I4 FOUNTAINS,DRINKING - x $6 = $
BIS WATER PIPING/DRAIN-WASTE-VENT INSTALLATION,ALTERATION OR REPAIR / x $6 = $
B16 SEWAGE EJECTORS GRINDER,SUMP PUMP X $6 = $
B17 WATER USING DEVICES ICE AND/OR COFFEE MAKER, X $6 = $
HOSE BIB,STEAMER,PROOFER,
CARBONATOR,SWAMP COOLERS
BS CROSS-CONNECTION DEVICES VACUUM BREAKER,CHECK VALVE, x $6 = $
AND R.P.B.P.D.FOR:VATS,SUMPS,
TANKS,BOILERS,&SPRINKLER SYSTEMS
B19 INTERCEPTORS GREASE TRAP,SAND TRAP, x $6 = $
CHEMICAL HOLDING TANK
3320 MEDICAL GAS(per outlet/bottle station) NITROUS,OXYGEN x $6 = $
B21 MISCELLANEOUS FiXTURES x $6 = $
Subtotal
NOTE: MINIMUM PERMIT FEE IS $35.00 PLUS: PROCESSING FEE $25.00
I TOTAL PERMIT FEE DUE $ 4 3.00
SIGNATURE• ...,
SPOKANE COUNTY DIVISION OF BUILDINGS
WEST 1026 BROADWAY AVENUE*SPOKANE,WA 99260 i(509)456-3675
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