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1995, 03-24 Permit App: 95001675 Plumbing Reversal PLUMBING PERMIT APPLICATION .. 75 ,n f PROJECT ADDRESS: �� v�(� :� - L;411-e 1✓�7� ? ()6. OWNER: A L/i C� --7-1, ( S PHONE: MAILING ADDRESS: 4 /(,A.0 £7 /S f/ 5pc�ciCfxe ;i' /� 99 O 6 (street) (city/state) (zip) CONTRACTOR: k; ' $'/I( '/(Z,-- LICENSE:AI 1.„(3.,, G(, jr,&/S PHONE: J; �,S(1� MAILING ADDRESS: , C,/6e.y / // 5 [' 1 v/ C /"r, /y (street) ?r/'(./71.c(city/state) (zip) PLUMBING FIXTURES #OF MULTI- COST DESCRIPTION I DETAIL UNITS PLUM BY /UNIT BQUALS AMOUNT 1302TOILETS WATER CLOSETS,BIDETS I x $6 = $ B03 URINALS - x $6 = $ 1304 TUBS BATH,JACUZZI,SPA,GARDEN x $6 = $ B05 SHOWERS(per trap) BASE,STALL,ON—SITE BUILD x $6 = $ E06 SINKS LAVSBASINS,BAR,FLOOR,KITCHEN, x $6 = $ LAUNDRY,UTILITY,JANITOR,PHOTO, X—RAY,FOOD(PREP/CULINARY/MEAT) 130' DISHWASHER - x $6 = $ 1308 CLOTHES WASHER - x $6 = $ B09 GARBAGE DISPOSAUGRINDER - x $6 = $ 1310 WATER SOFTENER - x $6 = $ 81:1 ELECTRIC HOT WATER TANKS (NOTE: if gas water tank,see mechanical) x $6 = $ B12 FLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE x $6 = $ 1313 ROOF DRAINS/OVERFLOW DRAINS(ea.) - x $6 = $ 1314 FOUNTAINS,DRINKING - x $6 = $ 015 WATER PIPING/DRAIN-WASTE-VENT/ INSTALLATION,ALTERATION,REPAIR, x $6 = $ PLUMBING REVERSALS REVERSALS B16 SEWAGE EJECTORS GRINDER,SUMP PUMP x $6 = $ 1317 WATER USING DEVICES ICE AND/OR COFFEE MAKER, x $6 = $ HOSE BIB,STEAMER,PROOFER, CARBONATOR,SWAMP COOLERS 1318 CROSS-CONNECTION DEVICES VACUUM BREAKER,CHECK VALVE, x $6 = $ AND R.P.B.P.D.FOR:VATS,SUMPS, TANKS,BOILERS,&SPRINKLER SYSTEMS B191NTERCEPTORS GREASE TRAP,SAND TRAP, x $6 = $ CHEMICAL HOLDING TANK B20 MEDICAL GAS(per outlet/bottle station) NITROUS,OXYGEN x $6 = $ 1321 MISCELLANEOUS FIXTURES x $6 = $ NOTE: MINIM U M PERMIT FEE IS$35.00 Subtotal PLUS: PROCESSING FEE $25.00 SIGNATURE: K' /- TOTAL PERMIT FEE DUE $-5, 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)456-4703 *TDD No.(509)324-3166 UUSTERVLUSWERILHND