1990, 06-25 Permit App: 90002837 Residence iftpT rid le
Spokane County
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER:
STREET ADDRESS: / f 9 �� C
CITY/STATE/ZIP: c
SUBDIVISION: (1'x -T !�
BLOCK: l LOT: 7 ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: g4j DEPTH: 1 _.1- R/W:
# OF BUILDINGS: / # OF DWELLINGS: ` WATER DISTRICT:
OWNER: !/C�C.!/,l j{ 2 PHONE: -726 -3toS
MAILING ADDRESS: '7_ 0 , ./2z2yL
CITY/STATE/ZIP: f;;.67,c-
CONTACT:
� PHONE: - -
SETBACKS: - FRONT: LEFT: RIGHT: /,§ REAR: 4S--
PERMIT USE:
*, *************************************************************************
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: i.II S-TF4/Z. I? 11 ?-(
CONTRACTOR: PHONE: - -
MAILING ADDRESS:
ARCHITECT/ENGINEER: PHONE: - -
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT. :
REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
5E/ 8e
. f
PLUMBING PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS:
CITY/STATE/ZIP: PARCEL NUMBER:
OWNER: PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State) (ZiP)
4
PLUMBING WORKSHEET/FEE SCHEDULE
NUMBER OF X EACH
DESCRIPTION FIXTURES FIXTURE = AMOUNT
'.TOILETS I x $6.00 =
SINKS I x 6.00 =
w;
SHOWERS x 6.00 =
BATH TUBS 1 x 6.00
KITCHEN SINKS I x 6.00 =
DISHWASHERS . I x 6.00 =
GARBAGE DISPOSAL I x 6.00
, r CLOTHES WASHER 1 x 6.00 =
UTILITY SINKS x 6.00 =
ELECTRIC WATER HEATERS 1 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= $
SIGNATURE
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
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