1992, 10-20 Permit App: 92009129 RemodelSpokane County
DEPARTMENT OF BUILDINGS
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
c -fl125
PARCEL NUMBER:
INFORMATION WORKSHEET
STREET ADDRESS: E. l f l IO 7- h„1
CITY/STATE/ZIP: p 0 a-- ac1a,l a
SUBDIVISION:
BLACK: LOT: ZONE: DISTRICT:
LOT AREA: F/A: WIDTH: DEPTH: R/W:
# OF BUILDINGS:
# OF DWELLINGS: WATER DISTRICT:
OWNER: 09nn n c J; \gTt fl\ A PHONE: SOC( -01d,a, 5,16
MAILING ADDRESS: IF, 1 v, -;)-a,)3L),pty,,z
CITY/STATE/ZIP: `�-)n.s 15\Oada
CONTACT: pO%.".. o r,IS,A_ PHONE: per/ -
SETBACKS: - FRONT: LEFT: RIGHT: REAR:
PERMIT USE: ervipb etkirr 75.1r0
****************************************************************ef M *T**F E
BUILDING INFORMATION (41. 3 o re5
u.So 6�
CONTRACTOR LICENSE NUMBER: tQit r5.00 11 -
coed, LMeta.
CONTRACTOR: PHONE: - --��
MAILING ADDRESS:
ARCHITECT/ENGINEER: PHONE: - -
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
i
DWELL UNITS: OCCUPANT LOAD: BUILDING HGT: STORIES:
BUILDING DIMENSIONS:
X (WIDTH X DEPTH) SQ. FT.:
REQUIRED PARKING: # HANDICAP; SPRINKLERED: CRITICAL MATERIAL:
MECHANICAL PERM4T APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS:
CITY/STATE/ZIP: PARCEL NUMBER:
OWNER: PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State)
CONTRACTOR: LICENSE NUMBER:
(Zip)
PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT_ .=
GAS WATER HEATER
GAS EQUIPMENT <100,000 BTU (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET) ';'. ;
BOILER/REFRIG 1-100M BTU
.BOILER/REFRIG 10.1 500M BTU '- - -
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG'1,0001-1,750M BTU
BOILER/REFRIG +1,750M BTU
HEATPUMP &AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER 15-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP&AIR CONDITIONER +50 TONS
VENTILATING FANS
EVAPORATIVE,;QOOLER$ :'':';.,
TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD,.;
CLOTHES DRYER
RANGE
GAS LOG
:MISCELLANEOUS (NOTCOVERED-ELSEWHERE _`:
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANCE,>400,000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE>400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER>10,000
NOTE: MINIMUM PERMIT FEE IS $35.00
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= 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 =
Gv„_
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ 10 ,
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PLUMBING PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: e
CITY/STATE/ZIP: .►.:.`• \ PARCEL NUMBER:
OWNER:µ •\✓�h�hDa+1
�CdrNWI`M�
MAILING ADDRESS: Ac1.,-, p.c
CONTRACTOR:
MAILING ADDRESS:
HONE NUMBER: �0 °\�2.5�t.P
(Street)
(City/State) (Zip)
LICENSE NUMBER:
PHONE NUMBER:
(Street)
(City/State)
(Zip)
PLUMBING WORKSHEET/FEE SCHEDULE
DESCRIPTION
TOILETS
SINKS' .'
SHOWERS
BATHTUBS
KITCHEN SINKS
DISHWASHERS
GARBAGE DISPOSAL
CLOTHES WASHER
UTILITY SINKS
ELECTRIC WATER HEATERS
FLOOR DRAINS
FLOOR SINKS
BAR SINKS
ROOF DRAINS: -€L„.:.:.
LAWN SPRINKLER - FOR EACH BACKFLOW DEVICE
SEWAGE' EJ ECTO R . ;;,
WATER SOFTENER
URINAL' •
DRINKING FOUNTAIN
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
@w—
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 =
x6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
I 0
b. -v.-0 ,
Ln
S -,
(n
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
/ 64
= $ G
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675