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1989, 06-27 Permit App: 89001944 Water Softener •1. a. • PLUMBING PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: v," 2 i • /d CITY/STATE/ZIP: c j zikx,yt;L. PARCEL NUMBER: -�y Ind O-- OWNER: fii J ' e �1.tel PHONE NUMBER: 63t/ - s-z,3 MAILING ADDRESS: az) (Street) (City/State) (Zip) CONTRACTOR: a] (SiL�� LICENSE NUMBER: PHONE NUMBER: MAILING ADDRESS: T.o •3. 76 7 0.)11 9c/2Z t (Zip) ) (Ci y/State)y/ ) E P) PLUMBING WORKSHEET/FEE SCHEDULE NUMBER OF X EACH DESCRIPTION FIXTURES FIXTURE = AMOUNT TOILETS x $6. 00 = SINKS x 6. 00 = SHOWERS x 6. 00 = RATH TTTBS _ 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 x 6. 00 = WATER SOFTENER x 6. 00 = URINAL x 6. 00 = DRINKING FOUNTAIN x 6. 00 = SUBTOTAL $ 6202.- PLUS: V=PLUS: PROCESSING FEE + $ 25. 00 EQUALS: TOTAL PERMIT ' NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE 1 = $ ✓�- SIGNATURE ,,)0,,(ho 1 i` Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675