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1991, 10-18 Permit App: 91006989 Pellet StoveMECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: Ive2- 6t- '1\ki-rk. f cL CITY /STAT ZIP: (�IC�L�%� UJ} 904- PARCEL NUMBER: OWNER: i l l I G I1JY\ CP PHONE NUMBER: "-)2.5(-91 MAILING ADDRESS: k. n r £(o) (Street) (City /State) CONTRACTOR: LICENSE NUMBER: PHONE NUMBER: MAILING ADDRESS: (Zip) (Street) (City /State) MECHANICAL WORKSHEET /FEE SCHEDULE DESCRIPTION ELECTRIC /DUCTWORK (SEPARATE SYSTEMS) GAS WATER HEATER IPMEN7 X104 t) 0 IJ (INCLI DES GAS EQUIPMENT +100,000 BTU DUCTWORK) gigigAipm ET) . < BOILER/REFRIG 1 -100M BTU ............................... ............................... f / EF IG >1 t1 <::500 .............................. ............................... BOILER/REFRIG 501- 1,000M BTU IL ....... ............................... ...... ............................... BOILER/REFRIG +1,750M BTU 4DITIO 1 ER HEAT PUMP & AIR CONDITIONER 3 -15 TONS HEAT PUMP & AIR CONDITIONER 30 -50 TONS HE `PUMP & AIR CONDITIONS +50 TONS .......................... ............................... VENTILATING FANS ........................ ............................... �i/ 1PO RATIVE COOLS ........................................................................................ ............................... TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) • .............. ............................... CLOTHES DRYER GAS LOG M E A EO S O COVER EDELSEWHE UNLISTED GAS APPLIANCE <400,000 BTU ........ ............................... USED APPLIANCE <400,000 BTU .................. AIR HANDLER <10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNAT h /i A S (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 =S - 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 _$ SZ` V Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456 -3675 PLUMBING PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: CITY /STATE /ZIP: PARCEL NUMBER: OWNER: PHONE NUMBER: MAILING ADDRESS: (Street) (City /State) (Zip) CONTRACTOR: LICENSE NUMBER: PHONE NUMBER: MAILING ADDRESS: (Street) (City /State) (Zip) PLUMBING WORKSHEET /FEE SCHEDULE DESCRIPTION TOILETS SINKS SHOWERS .. ............................... BATH TUBS ... ............................... ... ............................... KITCHEN SINKS ...... ............................... DISH WASHE— ... ............................... ....................... .............................. GARBAGE DISPOSAL ........ ............................... ........................ ............................... CLOTHES:: WASHER ; ........................ ............................... 'UTILITY SINKS ELECTRIC WAT_ ............. ............................... FLOOR DRAINS ........... ............................... ............ ............................... FLO OR SINKS:; :::: . ............................... ............................... ............................... BAR SINKS ............................. .............................. LAWN SPRINKLER — FOR EACH BACKFLOW DEVICE SEW.AGEEJECTOR ......................... ............................... ........................ ............................... WATER SOFTENER URINAL DRINKING FOUNTAIN NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE NUMBER OF UNITS X EACH UNIT = AMOUNT 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 = x6.00 = x6.00 = x6.00 = x 6.00 = x6.00 = 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