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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. VjMe*WW-dv.....nP