1990, 07-12 Permit App: 90003258 Mechanical FixturesPLUING PERMIT APPLICATION FORD
Information Worksheet
5`''''s4 /c
JOB STREET ADDRESS : E. /2.1.02- S/ "
CITY/STATE/ZIP: S9p/4.1 k -, GFA_. PARCEL NUMBER:
OWNER: ,% r9 la M P77—
MAILING ADDRESS: Soz
PHONE NUMBER:
(Street)
CONTRACTOR: ,h, v v' Sees®lie.-t-4;10
MAILING ADDRESS: /3o x , 4 9
(Street)
(City/State) (Zip)
LICENSE NUMBER: Fo c.t R c i 3 6 X
PHONE NUMBER: 944- 4//9?
/441 [.J4 . 49 0Z/
(City/State) (Zip)
PLUMBING WORKSHEET/FEE SCHEDULE
DESCRIPTION
NUMBER OF
FIXTURES
X EACH
FIXTURE
= AMOUNT
TOILETS"::;
SINKS
SHOWERS
BATH -TUBS
KITCHEN:.SINKS•
DISHWASHERS
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
EQUALS: TOTAL PERMIT
FEE DUE
+ $ 25.00
= $
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
MECHANICAL PERMIT APPLICATIllk FORM
Information Worksheet
JOB STREET ADDRESS:
CITY/STATE/ZIP: PARCEL NUMBER:
OWNER:
MAILING ADDRESS:
(Street)
CONTRACTOR:
PHONE NUMBER:
(City/State) (Zip)
LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(Street)
(City/State)
MECHANICAL.WORKSHEET/FEE SCHEDULE
DESCRIPTION
DUCTWORK ,SYSTEM '": ' -
WOODSTOVE/INSERT::
GAS WATER2,HEATER _
HEATING EQUIPMENT_ <100,000 BTU,
HEATING;EQUIPMENT #100,0.00 BTU
GAS PIPINEAG :.( OUTLET)
REFRIG :1 rt 10gM ;BTU :`(NOT A,
REFRIG X1,01„ti5PPk BWA
REFRIG 501' ;"1, 000M -;BTU
REFRIG,.1, 0.01 ;I,.750M4w.rU_...
REFRIG +1,750M BTU
HEAT. PUMP•• &'AIR },CONDITIONER : 0-3 TONS
HEAT -PUMP&,''AIR,' CONDITIONER; -3 15',.TONS _
HEAT PUMP & �..AIRV CONDITIONER; 15-30.,:TONS
HEAT = PUMP AIR:` CONDITIONER 3 0-50 :.TONS
HEAT PUMP ;.& .AIR'. CONDITIONER +50...TONS •_
VENTILATING:'. FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12;'. OR 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
NUMBER X EACH
OF UNITS UNIT
1
(Zip)
= AMOUNT
x$?0.00 =
x 25.00 =
X. 10.00 =
x:12.00 =
x 15.00 =
x .1.00
x 12.00_
x20.00=
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 =
/2.00
NOTE: MINIMIIM PEE IS $35.00 ,21.._
SIGNATUREP2
SUBTOTAL
$ G2S-$oo
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_ $ 50,00
Spokane County Department of Building_ and Safety
West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675