1992, 08-24 Permit Application: 92006771 Plumbing FixturesPLUMBING PI.RMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: 1-1-19 AL AW & &S %
CITY /STATE /ZIP: S POKAN E PARCEL NUMBER:
OWNER: / &/ 4- &u.e-✓ GLI to -L-0E--) PHONE NUMBER: 9.28- 4 S g S
MAILING ADDRESS: tom'.O lieL (5 5 (mooKaN 99A. S
(Street) (City /State) (Zip)
CONTRACTOR: 0 W Kt. E YZ LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(Street) (City /State)
(Zip)
PLUMBING WORKSHEET /FEE SCHEDULE
DESCRIPTION
TOILETS
.........................
::.......:..:.............
SHOWERS
KITCHEN SINKS
DISH WAS'HEI
..... ...............................
.... ...............................
GARBAGE DISPOSAL
CLOTH. ES;WASHE :
UTILITY SINKS
........ ...............................
E[ ECTRIC WATER H
FLOOR DRAINS
FL OOR SINK
..............................
............................
BAR SINKS
................. S .
ROOF DRAI...........
N
.........................
LAWN SPRINKLER - FOR EACH BACKFLOW DEVICE
......... ...............................
SEWAGE EJECTC
WATER SOFTENER
.......................
URINAL
DRINKING FOUNTAIN
TEi
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE-9
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
/
x 6.00 =
x 6.00 =
x 6.00 =
x6.00 =
x6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
/
/
/
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456 -3675
MECHANICAL PERMFT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS:
CITY /STATE/ZIP: PARCEL NUMBER:
OWNER: PHONE NUMBER:
MAILING ADDRESS:
(Zip)
(Street) (City /State)
CONTRACTOR: LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(Zip)
(Street) (City /State)
MECHANICAL WORKSHEET /FEE SCHEDULE
DESCRIPTION
ELECTRIC /DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/IN$......
GAS WATER HEATER
AS EQUIPMENT < 00,000 RTU QNCLUDE
GAS EQUIPMENT +100,000 BTU DUCTWORK)
:AS PIPING (EA C
BOILER/REFRIG 1 -100M BTU
SO_ILEFT/I SFRIG 1 ....:.....
BOILER/REFRIG 501- 1,000M BTU
ILER /F EFRIG: :1:,0001 -y 750M. S'IC
BOILER RREFRIG +1,750M BTU
CONDITIONER
HEAT PUMP & AIR CONDITIONER 3 -15 TONS
y_.
HEAT PUMP AIR CONDITIONER 1?5
HEAT PUMP & AIR CONDITIONER 30 -50 TONS
HEAT PUMP & AIR CONDITIONER +50 T
VENTILATING FANS
"PORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
H
CLOTHES DRYER
:RANGE >»
GAS LOG
1Er US N T COVE. ELSEWHEI
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANCE>400,!
USED APPLIANCE <400,000 BTU
L'ANI
AIR HANDLER <10,000 CFM
IR HANDLER 3'
NOTE: MINIMUM PERMIT FEE IS $35.00
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456 -3675
SITE ADDRESS: N 4419 ADAMS RD
PROJECT NUMBER: 92006771 PERMIT TYPES: PL
PERMIT USE: TOILET, SINK, BATH TUB, E KITCHEN SINK
DESCRIPTION INSPECTOR DATE RESULT
FINAL "CHIP" ALLEN 08/31/92 APPROVED