1995, 03-13 Permit App: 95001381 Plumbing Fixtures PLUMBING PERMIT APPLICATION '-75- 73 %
PROJECT ADDRESS: 1 c)f--07 : ''7 r/
OWNER: 1—.(-- 0 , 1:) / l D V N L. /4\--4) PHONE:DAYTIME CONTACT
MAILING ADDRESS: Z 7 1 t.-- t S t--( )ry U t (t `-5 6?)
(street) (city/state) (zip)
CONTRACTOR: S y -<-__( LICENSE:
PHONE:
MAILING ADDRESS: 5/\.-f
(street) (city/state) (zip)
PLUMBING FIXTURES #OF MULTI- COST
DESCRIPTION I DETAIL UNITS F BDNY /UNIT eou z.s AMOUNT
1302 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—SITE BUILD x $6 = $
1306 SINKS LAVS/BASINS,BAR,FLOOR,KITCHEN. x $6 = $
LAUNDRY,UTILITY,JANITOR PHOTO,
X—RAY,FOOD(PREP/CULINARY/MEAT)
B07 DISHWASHER - x $6 = $
1308 CLOTHES WASHER - x $6 = $
1309 GARBAGE DISPOSAUGRINDER - x $6 = $
BiG WATER SOFTENER - x $6 = $
Bl l ELECTRIC HOT WATER TANKS (NOTE: if gas water tank see mechanical) x $6 = $
4312 FLOOR DRAINS AREA,CASE,COIL TRENCH,CONDENSATE x $6 = $
B13 ROOF DRAINS/OVERFLOW DRAINS(ea.) - x $6 = $
B14 FOUNTAINS,DRINKING - x $6 = $
B1S WATER PIPING/DRAIN-WASTE-VENT/ INSTALLATION ALTERATION,REPAIR, x $6 = $
PLUMBING REVERSALS REVERSALS
B1:6 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
'BIB CROSS-CONNECTION DEVICES VACUUM BREAKER,CHECK VALVE, x $6 = $
AND ILP.B.P.D.FOR:VATS,SUMPS,
TANK$BOILERS,&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 1 x $6 = $
NOTE: MINIMUMPERMIT IS$35.00 Subtotal
/� PLUS: PROCESSING FEE $25.00
SIGNATURE: "` r �, TOTAL PERMIT FEE DUE $
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.