1994, 10-21 Permit App: 94010490 Plumbing Reversal •r
PLUMBING PERMIT APPLICATION 4.1,1_,,/0 LI 7 1
PROJECT ADDRESS:
OWNER: PHONE:
MAILING ADDRESS:
(street) (city/state) (zip)
CONTRACTOR: Pj Qsi' e P 1 • '1 40. LICENSE: a A * II 1 7--
PHONE: GI2.2.. is Lt
MAILING ADDRESS: I e LH b E. A l j (etre e a i,5 tV a Gj q�� (,
(street) (city/state) (zip)
1 I PLUMBING FIXTURES I # OF 1MULTI- I COST
DESCRIPTION I DETAIL I lJjVi.IS Irunowri /UNIT I nouwsLi.a_{OU1'tl T
B02 TOILETS WATER CLOSETS,BIDETS x $6 = $
B03 URINALS - x $6 = $
B04 TUBS BATH JACUZZI,SPA.GARDEN X $6 = $
P05 SHOWERS(per trap) BASE,STALL,ON-SITE BUILD x $6 = $
80.6 SINKS IAVS/BASINS,BAR FLOOR KITCHEN, x $6 = $
LAUNDRY,I TrILTLY,JANITOR PHOTO,
X-RAY,FOOD(PREP/CULINARY/MEAT)
80.7 DISHWASHER - x $6 = $
B08 CLOTHES WASHER - x $6 = $
1309 GARBAGE DISPOSAUGRINDER - x $6 = $
B1Q WATER SOFTENER - x $6 = $
E.1 ELECTRIC NOT WATER TlKJ ,;.qJli,ia wiac,Lin:,ace LO.Ya11ill) X SG- = $
B2 FLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE X $6 = $
01:3 ROOF DRAINS/OVERFLOW DRAINS(ea.) - x $6 = $
B14 FOUNTAINS,DRINKING - x $6 = $
1315 WATER PIPING/DRAIN-WASTE-VENT/ INSTALLATION,ALTERATION,REPAIR, I X $6 = $
>>PLUMBING REVERSALS REVERSALS
>B16 SEWAGE EJECTORS GRINDER,SUMP PUMP x $6 = $
B1:7 WATER USING DEVICES ICE AND/OR COFFEE MAKER, X $6 = $ `
CARBONATOR,SWAMP COOLERS
B18 CROSS-CONNECTION DEVICES VACUUM BREAKER CHECK VALVE, X $6 = $
AND R.P,B.PD.FOR:VATS SUMPS,
TANKS,BOILERS,&SPRINKLER SYSTEMS , ,
.14, INTERCEPTORS GREASE TRAP,SAND TRAP, x $6 = $
CHEMICAL HOLDING TANK
120 MEDICAL GAS(per outlet/bottle station) NITROUS, x $6 = $
821:MISCELLANEOUS FIXTURES -- �- '•,-��'C7 7 x $6 = $ e
so
i
NOTE: MINIMUMPERMIT FEE IS$35.00 Subtotal ,
d../... .,..,.. PLUS: PROCESSING FEE $25.00
SIGNATURE: ) �y -�J TOTAL PERMIT FEE DUE
t
...................................................................................................
.... ...........................................................................................
.................................................................................................
.... .........................................................................................
.................................. ........ .. ........................ ...............
................................................... .................. ................
................................. ........ .. ........................ ...............
................................................... .................. ................
..... ........................... ........ .. ........................ ...............
.................................................... .................. ................
........... ...... ................................................................. ....
........................... .......................................................................
................................ ................................................................
............... .......... ....................................................... ...
.$LEASE MAKE.. H4.PP: TA AB,I.E •P
..... . *::i:......... :i:::........... .................:.................:....:..... ::::.....
.......................................................... ....................................
................. .........................................................................
......................................................... ....................................
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
WAST*!PWMPIEMW(D
OCT-21—'94 FRI 07:22 ID:LI OLY DIA TEL NO: 13852 P01
Department of Labor&Industries REGISTRATION VERIFICATION
Contractor Registration Section
PO Box 44450
'
Olympia WA 98504-4450 '"
(206)956-5226
SCAN 269-5226
FAX(206)
956-5228
To (1, e�'
Olympiaes artefs
Regis naGme
UgCl7i/9i,v a/,/
Rcgistrauon number
C 0 aRc C / R/ exc —
Contractor: Your Certificate of Registration will be sent from the Olympia office and
should be received within 2 to 3 weeks. Please keep this record until you receive your
Certificate of Registration.
Thank you
F625-036-000 registration verification 4-93
Fx