1990, 03-12 Permit App: 90000821 ResidenceSPOKANE COUNTY DEPAR TMENT'OF BUILDING AND SAFETY
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509)456-3675
I certify that I have examined this permit/application, state that the information contained in it and submitted by me or my agent to compile said permit/application is true
and correct, and authorize Spokane County to proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to comply with same. All provisions of laws and ordinances governing this type of work will be complied with whether specified
herein or not. I understand that the issuance of this permit/application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel the provisions of any state or local law regulating construction, oras a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
PROjECT NUMBER= 90000a2!
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SpokaneCounty4//vPaci=z-
DEPARTMENT OF BUILDING & SAFETY
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
INFORMATION WORKSHEET
PARCEL NUMBER:
STREET ADDRESS: c3.,, /4- „gr,//4/,4>w
CITY/STATE/ZIP: //g-t-re---c-efee-er/) / 4-e/e:r_Y ;7
SUBDIVISION: L—t11-
BLOCK: 7 LOT: 3 ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH:/2.) R/W:
# OF BUILDINGS: / # OF DWELLINGS: / WATER DISTRICT:
OWNER: Ge/ s //e/
MAILING ADDRESS:
CITY/STATE/ZIP:
CONTACT: •42--tf%"-E,
aAz
PHONE: -.9 Z z--
PHONE:
SETBACKS: - FRONT: 2'1' LEFT: /7 RIGHT / REAR:
PERMIT USE:
*******************************************************************
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: 1-Lj S ,4 S ,2 'r 44 6 -
CONTRACTOR: it,C PHONE: - 0901_
MAILING ADDRESS: ee?-//y7
ARCHITECT/ENGINEER: PHONE:
MAILING ADDRESS:
NEW: >4 REMODEL ADDITION CHANGE OF USE:
DWELL UNITS: / OCCUPANT LOAD: BUILDING HGT: STORIES:
BUILDING DIMENSIONS: X (WIDTH X DEPTH) SQ. FT.:
REQUIRED PARKING: # RABDICAP: SEWER (Y/N): HYDRANT:._ _
JOB STREET ADDRESS:
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
l/4//
CITY/STATE/ZIP: 1. •-e-
79 7 3
OWNER: Z(//(7,c- PHONE NUMBER:
PARCEL NUMBER:
MAILING ADDRESS:
(Street)
CONTRACTOR: z/} £ S Y d -L --
MAILING ADDRESS:
(City/State)
LICENSE NUMBER:
PHONE NUMBER:
(Street)
(Zip)
(City/State)
(Zip)
MECHANICAL WORKSHEET/FEE SCHEDU
NUMBER
OF UNITS
DESCRIPTION
E
X EACH
ITNIT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (EA OUTLET)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
0-3 TONS _
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU_
UNLISTED GAS APPLIANCE >400,000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM
= AMOUNT
x$10.00 =
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 =
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
$ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $
Spokane County Department of Buildinq and Safety
West 1303 Broadwav Avenue Spokane, WA 99260 (509) 456-3675
JOB STREET ADDRESS:
PLUMBING PERMIT APPLICATION" FORM
Information Worksheet
� 2 /J C i eV/ -
CITY/STATE/ZIP: //c -rt -t...- /,/�c< PARCEL NUMBER:
%f62?
OWNER:
MAILING ADDRESS:
CONTRACTOR:
PHONE NUMBER:
(Street)
MAILING ADDRESS:
(City/State) (Zip)
LICENSE NUMBER:
PHONE NUMBER:
(Street)
(City/State) (Zip)
PLUMBING WORKSHEET/FEE SCHEDULE
DESCRIPTION
NUMBER OF
FIXTURES
X EACH
FIXTURE
= AMOUNT
TOILETS
SINKS
SHOWERS
BATH TUBS
KITCHEN SINKS
DISH WASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
UTILITY SINKS
ELECTRIC WATER HEATERS
FLOOR DRAINS
FLOOR SINKS
BAR SINKS
ROOF DRAINS
LAWN SPRINKLER
SEWAGE EJECTOR
WATER SOFTENER
URINAL
DRINKING FOUNTAIN
3
/
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 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
1
+ $ 25.00
EQUALS: TOTAL PERMIT'
FEE DUE i= $
� i 1
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (5 9) 456-3675
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