1990, 05-01 Permit App: 90001797 ResidenceSPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY -AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that 1 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 e issuance . permit/application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authoritytoviolateorc nth-.rovisi.nsofnystat r local law regulating construction, or as a warranty of conformance with the provisions of any state or local
laws regulating constructio
SIGNATURE OF
OWNER OR AGENT
APPLICATION 5 , .70
DATE
, !•.. ft::. k.: t NUMBER= 90001797 DATE= )1/90
APPLICATIuN
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PLUMBING PERMIT
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ADDRESS= r WA 99214
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Spokane County
____________4RTMENT OF BUILDING & SAFETY
ladway Avenue Spokane, WA 99260 (509) 456-3675
.tiER:
INFORMATION WORKSHEET
c260 PI4
STREET ADDRESS: f3 , ,5 -7, ---ea Cr_ (() 6-7L4-02-J-
CITY/STATE/ZIP:
SUBDIVISION: A: CP0Oxe S�4
BLOCK: / LOT: /oZ ZONE: DISTRICT:
LOT AREA: F/A:i WIDTH: DEPTH:0
R/W: ��
# OF BUILDINGS: / # OF DWELLINGS: WATER DISTRICT: /�
M
OWNER: 04 j
MAILING ADDRESS:
CITY/STATE/ZIP:
CONTACT:
POd1Q
&.„„,(1,,41
PHONE:
-702Y - 696 /
(LAG 79a f y
PHONE:
SETBACKS: - FRONT.
" 30LEFT: RIGHT: REAR:
PERMIT USE:
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *, * * * * * * * * * * * * * * k
BUILDING INFORMATION
CONTRACTOR LICENSE NUMBER: 547/0.) L dC
/5y M �
CONTRACTOR: i .t QG i
/903W 141( 79°201
MAILING ADDRESS:
PHONE:
ARCHITECT/ENGINEER:
PHONE:
MAILING ADDRESS:
NEW:1L REMODEL: -- ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD:
BUILDING HGT: STORIES: /
BUILDING DIMENSIONS: SS` x�j y (WIDTH X DEPTH) SQ FT_ : /493
REQUIRED PARKING: # HANDICAP: SPRINKLERED: CRITICAL MATERIAL:
PLUMBING PERMIT APPLICkfIOt( FORM
Information Worksheet
JOB STREET ADDRESS:
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
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
2_
f
f
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
=$
1
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
JOB STREET ADDRESS:
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
CITY/STATE/ZIP: PARCEL NUMBER:
OWNER:
MAILING ADDRESS:
CONTRACTOR:
MAILING ADDRESS:
(Street) (City/State) (Zip)
PHONE NUMBER:
(Street)
(City/State)
(Zip)
LICENSE, NUMBER:
'PHONE NUMBER:
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS. UNIT
DESCRIPTION
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER _
HEATING EQUIPMENT <100,000
HEATING EQUIPMENT +100,000
GAS PIPING (EA OUTLET)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP),
REFRIG 101-500M BTU.
BTU
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
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF -HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS;
+50 TONS
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
x25.00
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
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