1989, 06-06 Permit App: 89001611 Mechanical Fixture PLUMBING PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: 44"7 / ;
CITY/STATE/ZIP: S pcP.c L ct) PARCEL NUMBER:
OWNER: r Y:27 ',i PHONE NUMBER: 90 ( o //c
MAILING ADDRESS: LA,7c,t.}/ 5POk4c:�‹. tU4 zog
(Street) / (City/State) (Zip)
CONTRACTOR: LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State) (Zip)
PLUMBING WORKSHEET/FEE SCHEDULE
NUMBER OF X EACH
DESCRIPTION FIXTURES FIXTURE = AMOUNT
TOILETS x $6. 00 =
SINKS x 6. 00 =
SHOWERS x 6. 00 =
BATH TUBS x 6. 00 =
KITCHEN SINKS x 6. 00 =
DISH WASHERS x 6. 00 =
GARBAGE DISPOSAL x 6. 00 =
CLOTHES WASHER x 6. 00 =
UTILITY SINKS x 6. 00 =
ELECTRIC WATER HEATERS x 6. 00 =
FLOOR DRAINS x 6. 00 =
FLOOR SINKS x 6. 00 =
BAR SINKS x 6. 00 =
ROOF DRAINS x 6. 00 =
LAWN SPRINKLER x 6. 00 =
SEWAGE EJECTOR x 6. 00 =
WATER SOFTENER x 6. 00 -
URINAL x 6. 00 =
DRINKING FOUNTAIN x 6. 00 =
SUBTOTAL $
PLUS: PROCESSING FEE + $ 25. 00
1
EQUALS: TOTAL PERMIT
NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE 1 = $
SIGNATURE t
r
Spokane County Department of Buildingand Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
MECHANICAL PERMIT APPLICATION FORM
Information ;worksheet
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
NUMBER X EACH
DESCRIPTION OF UNITS UNIT = AMOUNT
DUCTWORK SYSTEM x$10. 00 =
WOODSTOVE/INSERT x 25. 00 =
GAS WATER HEATER x 10. 00 =
HEATING EQUIPMENT <100,000 BTU x 12 .00 =
HEATING EQUIPMENT +100,000 BTU x 15. 00 =
GAS PIPING (1 - 4 OUTLETS) x 4 . 00
GAS PIING (5 OR MORE. EACH: ) x 1. 00 =
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12.00 =
REFRIG 101-500M BTU x 20.00 =
REFRIG 501-1,000M BTU x 25. 00 =
REFRIG 1, 001-1,750M BTU x 35. 00 =
REFRIG +1,750M BTU x 60. 00 =
HEAT PUMP & AIR CONDITIONER 0-3 TONS _ _ x 12. 00 =
HEAT PUMP & AIR CONDITIONER 3-15 TONS _ x 20. 00 =
HEAT PUMP & AIR CONDITIONER 15-30 TONS _ x 25. 00 =
HEAT PUMP & AIR CONDITIONER 30-50 TONS x 35.00 =
HEAT PUMP & AIR CONDITIONER +50 TONS _ x 60. 00 =
VENTILATING FANS X 10. 00 =
EVAPORATIVE COOLERS x 10. 00 =
TYPE I HOOD (PER 12 ' OR 12 ' PTN. OF HOOD) x 50. 00 =
TYPE II HOOD x 10. 00 =
CLOTHES DRYER x 10. 00 =
RANGE x 10. 00 =
GAS LOG x 10. 00 =
MISCELLANEOUS (NOT COVERED ELSEWHERE)_ _ x 10. 00 =
UNLISTED GAS APPLIANCE <400, 000 BTU_ _ _ x 50. 00 =
UNLISTED GAS APPLIANCE >400,000 BTU _ _ x100. 00 =
USED APPLIANCE <400,000 BTU x 50. 00 =
USED APPLIANCE >400,000 BTU x100. 00 =
AIR HANDLER <10, 000 CFM x 12 . 00 =
AIR HANDLER >10, 000 CFM x 15. 00 =
SUBTOTAL $
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMITT
NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE = $
SIGNATURE
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675