1994, 05-13 Permit App: 94004319 Plumbing Fixtures 6 Li o ► Ac
PLUMBING PERMIT APPLICATION L`763
PROJECT ADDRESS: I ( ? L I C , z S -'4' q 'D- 1-7 6 3 67
OWNER: V P rPc) l E__ PHONE:
MAILING ADDRESS: i i q -2- ) r . Zc FL > re2 kG,,1.. ._
—ii n v�(street)
(city/state) ,� 1 (Z1P)
CONTRACTOR: l ND i-1 U➢V1 /S ¢ n LICENSE: 1�/�/c1 ) %� O L7
C fiPHONE: S c:)- 31 - 66
MAILING ADDRESS: +U � 0D -fO kc,1,, Q.- q 7 ,Z C)7
(street) (city/state) (zip)
PLUMBING FIXTURES # OF MULTI- COST
DESCRIPTION DETAIL UNITS PLIED BY UNIT R•UALS AMOUNT
BO•TOILETS WATER CLOSETS,BIDETS I x $6 = $
BO.'URINALS - x $6 = $
BO' TUBS BATH,JACUZZI,SPA,GARDEN X $6 = $
BO'SHOWERS(per trap) BASE,STALL,ON-SITE BUILD I III x $6 = $
B00 SINKS LAVS/BASINS,BAR,FLOOR,KITCHEN, X $6 = $
LAUNDRY,UTILITY,JANITOR,PHOTO,
X-RAY,FOOD(PREP/CULINARY/MEAT) I
BO DISHWASHER - x $6 = $
BO:`CLOTHES WASHER - I x $6 = $
BO, GARBAGE DISPOSAL/GRINDER - x $6 = $
Bit WATER SOFTENER - x $6 = $
Bil ELECTRIC HOT WATER TANKS (NOTE: if gas water tank,see mechanical) x $6 = $
Bi:.4 FLOOR DRAINS AREA,CASE,COIL,TRENCH,CONDENSATE X $6 = $
ID,'ROOF DRAINS/OVERFLOW DRAINS(ea.) — 111 x $6 = $
El' FOUNTAINS,DRINKI - x $6 = $
B ,WATER PIPING/.I RAI ZiF WAS aINSTALLATIO , I TERATIO. 0• REPAIR (,0 ' X $6 = $
B1 SEWAGE-EJECTORS GRINDER,SUMP PUMP {�� X $6 = $
BI WATER USING DEVICES ICE AND/OR COFFEE MAKER, x $6 = $
HOSE BIB,STEAMER,PROOFER,
CARBONATOR,SWAMP COOLERS
131: CROSS-CONNECTION DEVICES VACUUM BREAKER,CHECK VALVE, X $6 = $
AND R.P.B.P.D.FOR VATS,SUMPS,
TANKS,BOILERS,&SPRINKLER SYSTEMS
B1' INTERCEPTORS GREASE TRAP,SAND TRAP, x $6 = $
CHEMICAL HOLDING TANK
B21 MEDICAL GAS(per outlet/bottle station) NITROUS,OXYGEN X $6 = $
82 MISCELLANEOUS FIXTURES x $6 = $
NOTE: MINIMUM PERMIT FEE IS$35.00 Subtotal
PLUS: PROCESSING FEE $25.00
SIGNATURE: TOTAL PERMIT FEE DUE $
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 8 Fax No. (509)456-7403 • TDD No. (509) 324-3166
WASTERVLUMPERM.HND