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2008, 08-12 Permit App: 08003117 Mechanical Fixtures
JOB STREET ADDRESS: PLUMBING PER.APPLICATION FORM Information` Worksheet CITY/STATE/ZIP: PARCEL NUMBER: 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 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 + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 JOB STREET ADDRESS: MECHANICAL PELMI APPLICATION FORM Information Worksheet CITY/STATE/ZIP: PARCEL NUMBER: OWNER: PHONE NUMBER: MAILING ADDRESS: (Street) CONTRACTOR: (City/State) LICENSE NUMBER: PHONE NUMBER: MAILING ADDRESS: Street) (Zip) (City/State) {a x MECHANICAL:,. WORKSHEET/FEE . SCHEDULE. „ NUMBER X EACH ':.DESCRIPTION':::'', <,:, OF UNITS UNIT DUCTWORK',; SYSTEM_!:, WOODSTOVE/INSERT;' GAA S,,WTER HEAT HEATING ;:EQUIPMENT w.<100's;00 , HEATING ;',EQZJ;I.PMENT :.+iO0:. 0,00 GAS;. PIPING Px:(EA +OUTLET REFRIG?: 1 ## 10.QM BTU. ((TOT. A, NREFRIG'M10i 500M B REFRIG 50] 000M,`BTU4 ,, REFGH :� 1' Q,Q -2 7MifBTU ',, +' �` REFRIRIG+1 75,0M ;+5,0BTU+ : r° _ _ HEAT:'. PUMP;"ry �c "''AIR CONDITIONER;;0-. -;TONS;, ' L. ,HEATPUMP AIR,,':; CONDITIONERt3-15 +.TONS HEAT.:PUMPt & :AIR CONDITIONER 15-30;,;lTONS HEAT; PUMPY `.&yAIR (.'CONDITIONER 3 0=, 50 "-,.TONS HEAT'`::PUMP:,'..,&'}m:AIR''.CONDITIONER.+50.,,TONS , VENTILATING:. FANS' '} ,; •�J _ "' snit EVAPORATIVE•,:`COOLERS _ TYPE, I-HOOD.;,•(PER:_12�!.,.'OR 12'. PTN.; .OF' HOOD) TYPE':II HOOD CLOTHES DRYER RANGE MISCELLANEOUS- (NOT:COVERED ELSEWHERE)_ UNLIS.TED,•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 1 (Zip) = 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 Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675