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1989, 06-23 Permit App: 89001898 Gas Piping
PLUMBING PERM -ft APPLICATION FORM Information Worksheet JOB STREET ADDRESS: CITY/STATE/ZIP: PARCEL NUMBER: OWNER: f PHONE NUMBER: & MAILING ADDRESS: 2 2 /� (Street) ity/State) (Zip) CONTRACTOR:_t�..16-� �F LICENSE NUMBER:hh�'�//�/7 �✓M r- PHONE NUMBER: MAILING ADDRESS: 3"7ZAV 224r C /" cs .- (Street) City/State) (Zip) PLUMBING WORKSHEET/FEE SCHEDULE DESCRIPTION NUMBER OF I X EACH FIXTURES IFIXTURE = 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 , Ix $6.00 =� jx 6.00 =� Ix 6.00 =1 Ix 6.00 =1 jx 6.00 =1 Ix 6.00 =1 ( jx 6.00 =1 jx 6.00 =) x 6.00 =� Ix 6.00 =� Ix 6.00 =� ( jx 6.00 =1 jx 6.00 =1 Ix 6.00 =1 Ix 6.00 =) Ix 6.00 =1 Ix 6.00 =1 Ix 6.00 =1 Ix 6.00 =1 SUBTOTAL $ NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE PLUS: PROCESSING FEET+ $ 25.00 EQUALS: FEEDUE AERMITi- $ I Spokane County Department of Buildin and Safety West 1303 Broadway Avenue Spokane, WA A260 (509) 456-3675 MECHANICAL. PERMIT APPLICATION FORM Informati6nAlUrksheet, 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) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION OF UNBITS I XS = AMOUNT DUCTWORK SYSTEM_ WOODSTOVE/INSERT _ _ _ _ _ _ _ _ _ _ GAS WATER HEATER_____ ______ HEATING EQUIPMENT_<100,000 BTU _ _ _ HEATING EQUIPMENT +100,000 BTU _ _ _ _ _ GAS PIPING (1 - 4 OUTLETS) _ _ _ _ _ _ _ GAS PIING (5 OR MORE. EACH:)_ _ _ _ _ _ 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 & 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 COOLERS_ 5R7 -1i _ _ _ _ _ _ _ _ _ TYPE I HOOD (PER 12' O 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 _ _ _ _ _ _ _ _ NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 x$10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x 4.00 = 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 = $ Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675