1996, 08-26 Permit App 96006980 Plumb Reversal, DrainPROJECT ADDRESS:
OWNER:
MAILING ADDRESS:
CONTRACTOR:
MAILING ADDRESS:
PLUMBING PERMIT APPLICATION
I -,5;-L—� S �-rb<�rl- <=L�N�a ;/7
6 pF oNE: DAYTIME CONTACT
(street) (city/state)
(street) (city/state) (zip)
INTERCEPTORS
DESCRIPTION DETAIL
UNI
aartn-
n.mssr
fUNIT
LuJAMOUNT
S
.B02
TOILETS
WATER CLOSETS BIDETS
x
$6
=
$ L
�.
URINALS
-
x
$6
=
$
4
TUBS
BATH.JACUZZ1. SPA, GARDEN
PLUS: PROCESSING FEE
x
$6
=
$
B05
SHOWERS per trap
EASE. STALL ON-SITE BUILD
x
S6
=
$
B66
SINKS
LAVSBASINSBAR, FLOORKITCHEN,
LAUNDRY, UTII.RY, JANITOR PHOTO,
X-RAY,FOOD REP/CULINARYAMA
j'
1
x
$6
=
$
��`��
B07
DISHWASHER
-
x
$6
=
S
CLOTHES WASHER
-
x
$6
=
$
GARBAGE DISPOSAUGRINDER
x
S6
=
S
B10
WATER SOFTENER
-
x
$6
=
S
B1I
ELECTRIC HOT WATER TANKS
(NOTE: if gas water tank seemechaniral)
x
$6
=
S
B12
FLOOR DRAINS
AREA CASE, 00I1- TRENCH. CONDENSATE
x
$6
=
S
B13
ROOF DRAINS/OVERFLOW DRAINS ea.
-
x
S6
=
S
B1'
FOUNTAINS, DRINKING
-
x
S6
=
S
B.
WATER PIPING/DRAIN-WASTE-VENT/
PLUMBING REVERSALS
INsTALLAnoN, ALTERATioN, REPAm,
REVERSALS
f
x
$6
=
$
'Elm
SEWAGE EJECTORS
GRINDER SUMP PUMP
x
S6
=
$
B17
WATER USING DEVICES
ICE AND/OR COFFEE MAKER,
HOSE BIB STEAMER PROOFER
CARBONATOR SWAMP COOLERS
x
S6
=
$
B1CROSS-CONNECTION
_...
DEVICE$
VACUUM BREAKER CHECK VALVE
AND R.P.BPD. FOR: VATS SUMPS,
x
S6
=
$
B
...;-.
INTERCEPTORS
GREASE TRAP. SAND TRAP.
CHEMICALHOLDINGTANK
x
$6
=
S
$2 ,
MEDICAL GAS per outlet/bottle station
NITROUS OXYGEN
I x
S6
=
$
B21
MISCELLANEOUS FIXTURES
I x
I S61
$
NOTE:PEWT FEE IS $35.00
SIGNATURE:7L;�Nr) l—,
SIGNATURE:
Subtotal
PLUS: PROCESSING FEE
$25
TOTAL PERMIT FEE DUE
Spokane County Division of Buildings SYVICAN$ (.UU1V l; Y r -xM11 Ur.N.
1026 W. Broadway Avenue' Spokane, WA 99260
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.
1Y 5�eo'' mhh
SEWER CONNECTION PERMIT �,Q `�17
APPLICATION FORM
PLEASE NOTE: This application form must be filled out accurately and in its entirety, and Signe , or pe t
will not be issued. Also note that sewer permits are valid for 12 months from the date of issuance. No
extensions will be granted.
PROJECT INFORMATION
Job address:/� Dry Line O 's name:
fI ZIN tsY (a d� ��co Sewer? (YIN) 7:s6 n l , a�'L_a l i '_
Zip: dC 't -_� f, "I Zip:
Parcel number (if known): Phone:
Jl� lq�'1?—,
First-time contractors or home -owners performing the installation must first contact the utilities department (in person
or via phone [456-3604]) before a permit can be issued.
Name of Utilities Division person contacted:_,C27 ! f �—_.t-
Business address:
City/State:
Zip: Phone:
CONTRACTOR INFORMATION
State contractor license number:
Utilities installers permit number:
INTERIOR PLUMBING ALTERATIONS? (yes/no) circle one
Fill out the information in the table below if applicable**
Contractor (if different from above): Phone:
Business Address:
Sewer Connection: Number of Buildings
City/State/Zip:
FEE INFORMATION
X (times) $50 (per bldg)
TOTAL FEE
* One permit required for each separate building, shop, garage, etc, that will be connected to the sewer.
* Condos, townhouses, & 2- 3- and 4 plexes require I permit per address/stub.
*Multiple buildings (apartments, industrial complexes) require I permit per building.
(For situ of covered e, c he County Utilities Division @ 456-3604)
APPLICANT SIGNATURE: �_6 CSS 1 I c Date: �— Z6 —
Spokane County Division of Buildings
West 1026 Broadway Avenue * Spokane, Washington 99260
PHONE: (509) 456-3675 * FAX: (509) 324-3198 * TDD: (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.
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