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1995, 06-15 Permit App: 95004313 Plumbing Reversal PLUMBING PERMIT APPLICATION 4--/ -- 0 Li. C 1 07 PROJECT ADDRESS: \0�c?t] .k E - 9 — A\t- 1 )r\c - (c)�, \ ' t t ti!' OWNER: \ \-\o----\ K S �� :-------- --H C \ S 1 PHONE:DAYTIME CONTACT 360 -s 7 tf-- ,)s(D MAILING ADDRESS: \-59 1 S t\,\,J I (1 CR - \/cam�-€t,, x,-0-\, l-J A 1 '6, (street) (city/state) (zip) 7NTRACTOR: t �� ti �t`)c; C-6 ti LICENSE: k-> ,' )c ci),.,:>:-K-D \,,.._9 0 2\t) PHONE: MAILING ADDRESS: (street) (city/state) (zip) PLUMBING FIXTURES #OF MULTI- COST DESCRIPTION I DETAIL UNITS PLIED BY /UNIT EQUALS AMOUNT B02 TOILETS WATER CLOSETS,BIDETS x $6 = $ B03 URINALS - x $6 = $ B04 TUBS BATH,JACUZZI,SPA,GARDEN x $6 = $ 'B05 SHOWERS(per trap) BASE,STALL ON—Sf'E BUILD x $6 = $ B06 SINKS LAVSBASINS BAR,FLOOR,KITCHEN, x $6 = $ LAUNDRY,UTILTI'Y,JANITOR,PHOTO, X—RAY,FOOD(PREP/CULINARY/MEAT) B07 DISHWASHER - x $6 = $ B08 CLOTHES WASHER - x $6 = $ 1309 GARBAGE DISPOSAL/GRINDER - x $6 = $ B10 WATER SOFTENER - x $6 = $ Bit ELECTRIC HOT WATER TANKS (NOTE: if Ins water tank,see mechanical) x $6 = $ B12 FLOOR DRAINS AREA,CASE,COIL TRENCH,CONDENSATE X $6 = $ B13 ROOF DRAINS/OVERFLOW DRAINS(ea.) - x $6 = $ 1314 FOUNTAINS,DRINKING - x $6 = $ B15 WATER PIPING/DRAIN-WASTE-VENT/ INSTALLATION ALTERATION,REPAIR, I x $6 = $ PLUMBING REVERSALS REVERSALS 6 B16 SEWAGE EJECTORS GRINDER,SUMP PUMP x $6 = $ B17 WATER USING DEVICES ICE AND/OR COFFEE MAKER, x $6 = $ HOSE BIB,STEAMER,PROOFER, CARBONA1DR,SWAMP COOLERS B18 CROSS-CONNECTION DEVICES VACUUM BREAKER,CHECK VALVE, X $6 = $ AND R.P.B.P.D.FOR:VATS,SUMPS, TANKS BOILERS,dt SPRINKLER SYSTEMS B19 INTERCEPTORS GREASE TRAP.SAND TRAP, X $6 = $ CHEMICAL HOLDING TANK B20 MEDICAL GAS(per outlet/bottle station) NITROUS,OXYGEN X $6 = $ B21 MISCELLANEOUS FIXTURES x $6 = $ NOTE: MINIMUMPE• FEE IS$35.00Subtotal , e ` _ PLUS: PROCESSING FEE $25.00 SIGNATURE: \- \ , `` ---_) TOTAL PERMIT FEE DUE Si3e• PLEASE MAKE CHECKS PAYABLE TO Spokane County Division of Buildings SPOKANE COUNTY PERMIT CENTER 1026 W.Broadway Avenue*Spokane,WA 99260 Tel.No.(509)456-3675 *Fax No. (509)324-3198 *TDD 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. lows WrryYRs,aYd