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1990, 09-25 Permit App: 90004876 Plumbing, Mechanical Fixtures• JOB STREET ADDRESS: PLUMBING PERtv1IT'aPPLICATION FORM Information Worksheet CITY/STATE/ZIP: PARCEL NUMBER: OWNER: PHONE NUMBER: MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: MAILING ADDRESS:' • LICENSE NUMBER: PHONE NUMBER: (Street):. -(City/State) (Zip) PLUMBING WORKSHEET/FEE SCHEDULE DES CRI PTI ON“ i_e4 t: NUMBER OF FIXTURES X EACH FIXTURE AMOUNT_.' TOILETS; SINKS , a BATH*)TUBS`•, "KITCHEN,.SIN -tiy,(DISH�!.WASHERS � ; ', "• GARBAGE. DISPOSAL y''CIATHESx WASHERS HtY,UTILITY ,SINKS;;ri t ),ELECTRI C , WATERS' HEATER FIAOR,DRAINS';' w.FLOOR SINKS BAR; SINKS ''; i ROOF., , DRAINS ), „ r` LAWN' SPRINKLER` ;SEWAGE,EJECTOR WATER SOFTENER_ URINAL DRINKING FOUNTAIN / x $6.00 = x' 6:00 = x 6.00 = x 6.00 = ” x 6.00 = 6.00 6:'00 = ,6c00 - = i6: 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 SIGNATURE SUBTOTAL PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 • N JOB STREET ADDRESS: MECHANICAL PERMIXAETLICATION FORM Information Worksheet CITY/STATE/ZIP: PARCEL NUMBER: OWNER: MAILING ADDRESS: PHONE NUMBER: r •.(Street) ;•• • •t •(City/State) (Zip) CONTRACTOR:IL' : : ',•••‘) ' ' LICENSE-. NUMBER: t••• 41; -;•r• ••• -• S,17e4V1.1tf • ;44;/,-;' 14 (' 141/4-5/, MAILING ADDRESS:- " >2:"...,•:-/P-7-•""• ." . • • •:;:: fu; 4' '7' • 2- 14-2-4; . r.(stie et) .",.;'•!.t . • . • r -g- ; 414,11-;44ECHANICAL ‘i:WORKISHEET4FEE A:SCHEDULE tbt.t1 . sAibn.0 DES#IFTI9Iigrii4;akt, DUCTWORK: SYSTEM Y" INTOODStovE/INSERTStet.L0-2....;•:•gZakia,*.li-2:4..i1;:itERtigr • GAS:iWATER,%/1E•ATERZ4:..14Lite-MicitEgli-Pittral-agt!(1,iti,e.$ '•• mEATIEQPIPtf.iyg'§gditt,, HEATINGEQUIpMENtaAppl 'p003BT94:.:514.11414.1tee GAS PING CA EA6OUTIST) • REFRIG;;L:17.-7,10,0m;21. ,,:;,(144:7PA/cit,OR4HEATOUMPO grtiv, ?. REFRIG5.61..÷13-00 kEFRI6 i; .0M'c ..30...111:_;7.,5\1..„`"EviAfpJ5; -2",,:FA,.r'Fst<,7,...(4.4,44724/7441"t94 REFRios t.r27sbmiBTUjIptAg.F'7416v.,-1.44:.,, f:••.:,,,,HEAT%PUMPirrahrAIR-•:CONDIT-I,ONERNO-3MTONS.040tr, A2- m'au 11EXTM.114P:602AITttfiC911,9,1211 TO,NgW,40,;,711NeT9NS,(4,, HEAVPUMP.'f&IAIRt;:CON ITIONER743:.0A5.0•4TONSM:" VENTILATING ,--T-4-2-4,4” "01, 114,,vk 44) w •/ EVAPORATIVE ;60OLERS000,14iSO:SiVt.,NWOr.41g7r,;:' .TYPE 1 MOOD (PER'12 OR/12 PTN0F HOOD) •.,CLOTMES,;.DRY'ER':i4,!2k.‘;•-•c?;;;rt:,MHA :••• RANGE, GAS LoGmi .;:. ; ,.2 • !fri?it 'tf ; ft, titlakelifottWt; 11^,i1z:i.VkiT-.00e0)4`it;;:ref:'; twrietifrilNIKW4v:li, fe:01,,VSktiViin,00, eitilifit000,CAVS tC4TACVAMANttg i.,:ncAtinTat'51. 1(.1 =. AMOUNT , . ,X0•1000,-= .X).(a5 '100 vl= iXOttli.t 0 0 Nt: ie?;12 x2J20:.,00 *A#Akfor4 ,ien35?bae- )g,t1Y.25,000,' ximt25:009. Sta'254Y.064r=: 1.6000%= • tv, *1000 i= MI scELLXNEOUs (R017: "EOVEREB ELSEFHERE ) ; UNLISTED. GAS. APPLIANCE <400; op o tirru••:11••• • . x/50.002= UNLISTED GAS APPLIANCE>400,000 x100.-00-= USED APPLIANCE <400,000 'BTU .'.'•:".1.!HI.L; . x 5000 -= USED APPLIANCE >400;000 BTU-. 2.; "- x100.00 = AIR HANDLER <10,000 .2- •••.; x 12.00 = AIR HANDLER >10,000 CFM x = .-•-•:;;••••/•. •••• 2.. „ 4. • 1: : • .1/4 • • • . NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE SUBTOTAL"'''.; ; St PLUS: fr PROCESSING 'FEE '+":" '251'00", EQUALS: TOTAL PERMIT FEE DUE = • Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675