1991, 05-06 Permit App: 91002343 Piping PLUMBING fidR'itml:j APPLICI,TION. 7ORM
Infoation Worksheet
JOB STF1:-.1;-.71T ADDRESS: ‘IF1O
CITY/ST, 11 i . .41). a
ki - 'PARCEL
Ar
OWNEF: C-5(-) el AV 'P'HONE t7 — 3 .23
MAILIN;7. DDRES
-
(Stres ) (Zip)
CONTP ACTOR: LICENSE
3ER:
MAILING ADDRESS:
(Street) (City/State)- (Zip)
PLUMBING WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT =AMOUNT
TOILETS x 6.00 =
x 6.00 =
SHOWERS x 6.00 =
f
BATH x 6.00 =
KITCHEN SINKS x 6.00 =
DISHWASHERS x600 =
GARBAGE DISPOSAL x 6.00 =
CLOThES WASHER x600 =
UTILITY SINKS x 6.00 =
ELECTRIC WATER HEATERS x 6.00 =
FLOOR DRAINS x 6.00 =
FLOORSINKS ••••••:-:- x600 =
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 x600 =
DRINKING FOUNTAIN x 6.00 =
SUBTOTAL
PLUS: PROCESSING FEE + S 25.00
NOTE: MINIMUM PERMIT FEE IS $35.00 EQUALS: TOTAL PERMIT
FEE DUE = $
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675