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2004, 04-15 Permit App: BLD-04-04080 Plumbing Fixtures
PLUMBING PERMIT APPLICATION PROJECT _ PERMIT ADDRESS: C--,e __ (`GYeJ' Sit'�`S� USE: OWNER: PHONE (Daytime Contact): MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: LICENSE: MAILING ADDRESS: PHONE: (Street) (City/State) (Zip) PLUMBING FIXTURES #OF MULTI- COST/ DESCRIPTION DETAIL UNIT PLIED EQUALS AMOUNT S BY UNIT TOILETS WATER CLOSETS,BIDETS x $6 = URINALS - x $6 = TUBS - x $6 = SHOWERS(per trap) BATH,STALL,ON-SITE BUILDx $6 = LAYS/BASINS,BAR,FLOOR OEN SINKS LAUNDRY,UTILITY,JANITOR,P OTO,X- x $6 = 0C.., RAY,FOOD(PREP/CULINARY/MEAT DIS WASHE tt tt x $6....) = CLOTHES WASHER - x $6 = b GARBAGE DISPOSAL/GRINDER - x $6 = WATER SOFTENER - x $6 = ELECTRIC HOT WATER TANKS (NOTE: if gas water tank see mechanical) x $6 = FLOOR DRAINS AREA,CASE,COIL,TRENCH, x $6 = CONDENSATE , ROOF DRAINS/OVERFLOW DRAINS(ea.) - x $6 = FOUNTAINS,DRINKING - x $6 = WATER PIPING/DRAIN-IN WASTE- INSTALLATION,ALTERATION,REPAIR, x $6 = VENT/PLUMBING REVERSALS REVERSALS SEWAGE EJECTORS GRINDER,SUMP PUMPx $6 = ICE AND/OR COFFEE MAKER,HOSE BIB, WATER USING DEVICES STEAMER,PROOFER,CARBONATOR, x $6 = SWAMP COOLERS VACUUM BREAKER,CHECK VALVE,AND CROSS CONNECTION DEVICES R.P.B.P.D.FOR: VATS,SUMPS,TANKS, X $6 = BOILERS,&SPRINKLER SYSTEMS INTERCEPTORS GREASE TRAP,SAND TRAP,CHEMICAL x $6 = HOLDING TANK MEDICAL GAS(per outlet/bottle station) NITROUS,OXYGENx $6 = MISCELLANEOUS FIXTURES - X $6 = METHOD OF PAYMENT SUBTOTAL ElCASH ElCHECK 0 VISA ❑ MASTERCARD 0 DISCOVER PLUS: PROCESSING FEE $ 25.00 FAXED PERMITS WILL ONLY BE ACCEPTED WITH PAYMENT OF A MAJOR CREDIT CARD SUBTOTAL: MINIMUM PERMIT FEE IS$35.00 DATE: EXPIRES: PLUS: 16%REGIONAL PLANNING BANKCARD NUMBER: SURCHARGE AUTHORIZED SIGNATURE: TOTAL PERMIT FEE DUE Spokane County Division of Building&Code Enforcement 1026 West Broadway Avenue*Spokane,WA 99260-0050 Telephone No.(509)477-3675*Fax No. 477-7198*TDD No. (509)477-7133