1995, 09-05 Permit App: 95006955 Plumbing Reversal • r
PLUMBING PERMIT APPLICATION
`PROJECT ADDRESS: I D(o 12- C 1'. On_
OWNER: -I(7 y G C fit y L.- ( PHONE:DAYTIME CONTACT
MAILING ADDRESS: $D 7 -an � 1"-i. kYu . y'7 Zv
(street) (city/state) (zip)
CONTRACTOR: �� LICENSE:
PHONE: Z't1 - 3Qj1
MAILING ADDRESS: q .3 t 2 5 • F-12-0 ,24 Pc a� D , hit t c G-4-t..., i-14- tL c c1.0-Z-,--Z-
(street)
-zz
(street) / (city/state) / (zip)
PLUMBING FIX1 URLS if OF MULTI- COST
DESCRIPTION I DETAIL UNITS t.Io s /UNIT EQUAL; AMOUNT
BO TOILETS WATER CLOSETS,BIDETS x $6 = $
0URINALS - x $6 = $
TUBS BATH.JACUZZI,SPA,GARDEN x $6 = $
SHOWERS(per trap) BASE.STALL,ON-SITE BUILD x $6 = $
'.=SINKS LAVS/BASINS.BAR,FLOOR,KITCHEN, x $6 = $
LAUNDRY.U11UTY,JANITOR.PHOTO,
X-RAY.FOOD(PREP/CULINARY/MEAT)
` `:1 DISHWASHER - x $6 = $
CLOTHES WASHER - x $6 = $
EIfi GARBAGE DISPOSAL/GRINDER - x $6 = $
;titi.WATER SOFTENER - x $6 = $
fit ELECTRIC HOT WATER TANKS (NOTE: if Sas water tank,see mechanical) x $6 = $
0.0 FLOOR DRAINS AREA.CASE,COIL,TRENCH,CONDENSATE X $6 = $
iiii ROOF DRAINS/OVERFLOW DRAIN - x $6 = $
I FOUNTAINS,DRINKING - x $6 = $
Or!WATER PIPING/DRAIN-WASTE-VE INSTALLATION,ALTERATION,REPAIR, / x $6 = $
: PLUMBING REVERSALS REVERSALS
B1' SEWAGE EJECTORS GRINDER,SUMP PUMP x $6 = $
aa' WATER USING DEVICES ICE AND/OR COFFEE MAKER, x $6 = $
HOSE BIB,STEAMER,PROOFER,
CARBONATOR.SWAMP COOLERS
BE CROSS-CONNECTION DEVICES VACUUM BREAKER,CHECK VALVE, x $6 = $
AND R.P.B.P.D.FOR VATS,SUMPS.
TANKS.BOILERS,&SPRINKLER SYSTEMS
BI>:INTERCEPTORS GREASE TRAP,SAND TRAP, x $6 = $
CHEMICAL HOLDING TANK
lial MEDICAL GAS(per outlet/bottle stati NITROUS,OXYGEN x $6 = $
St MISCELLANEOUS FIXTURES x $6 = $
NOTE: MINIMUM PERMIT FEE IS $35.00 Subtotal
PLUS: PROCESSING FE $25.00
SIGNATURE: TOTAL PERMIT FEE DU$
PAYABLE::TOti
Spokane County Department of Building&Planning
WA 99260 ..........................................
Spokane,
Avenue
1026 W.Broadway 0
7
.:::::::::::::::::.:.:.::........................................................................
Tel.No. (509)456-3675•Fax No.(509)324-3198•TDD No. (509)324-3166
Spokane County does not discriminate on the basis of disability in the admission to,or treatment or employment in,its programs or activities.
7/6/93 X.w.k+omn.m.ra