1992, 12-23 Permit App: 92011160 WoodstoveMECHANICAL PERMIT APPLICATION FORM
Infognation Worksheet
JOB STREET ADDRESS: /01 / 5 £ s. 1/4 JX€ y co t y
o5
CITY/STATE/ZIP:Sftka we/ 1,L/42. 99cv_e 6 PARCEL NUMBER:
OWNER: f: R G(1a /4 e. r� PHONE NUMBER: 9.026 l 7/ 3
MAILING ADDRESS:/0`I/3- c 1%Ct.4,4e�e ua9/ ek(i_ktei LC/C2L ITAe
(Zip)
(Street) (City/State)
CONTRACTOR: LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(Zip)
(Street) (City/State)
MECHANICAL WORK
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
GAS EQUIPMENT +100,000 BTU DUCTWORK)
SGA&>;P..P1N..Ea. 1>.. ...
BOILER/REFRIG 1-100M BTU
4w/rey}:V!{7Y#:•r �!;�!:.v.!,a}r..r;l;
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG +1,750M BTU
a,� w,as.r..r-i::Yl:�iil'i::JF:r,'.::Y'{SKr::i�Y:iGk:k:1Iv�MI�Y►isYW..1!:xi.11••.v.::IY:S..I!%:�Y:�h:::::�:
HEAT PUMP & AIR CONDITIONER 3•
-
HEAT PUMP & AIR CONDITIONER 30-50 TONS
VENTILATING FANS
:CYf►C'vn k:�i (y'r'. wL CCI :i i::.:? ..:?fi ?ti#ty.<•:.5:rr :'.::
TYPE I HOOD (PER •
12' OR 12' PTN. OF HOOD)
>*=<<'>``<::�:.::.:
CLOTHES DRYER
}x?•}:4}••: •: }s�..f}v? i+��f:::J.}ii?:.:•i:•}}.v,4};?:i;: ti.?
....: w:.... v::::::v:::::::::?:: :{v::r..-. yr •: r..n,:::•, •.
GAS LOG
UNLISTED GAS APPLIANCE <400,000 BTU
}::T..}... :..:::.?
USED APPLIANCE <400,000 BTU
AIR HANDLER <10,000 CFM
• :.:::>:
NOTE: MINIMUM PERMIT FEE IS $35.00
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
l
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 =
p/5'1 al
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_$ 0--C,0ti;
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
JOB STREET ADDRESS:
PLUMBING PERMIT APPLICATION FORM
Information Worl(sheet
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)
PLUMBING WORKSHEET/FEE SCHEDULE
DESCRIPTION
TOILETS
SHOWERS
KITCHEN SINKS
D'ISH<ISHRS> <><
.......................:.......................
GARBAGE DISPOSAL
UTILITY SINKS.~.'
FLOOR DRAINS
BAR SINKS
E:OO
LAWN SPRINKLER - FOR EACH BACKFLOW DEVICE
WATER SOFTENER
DRINKING FOUNTAIN
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
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
x6.00
x6.00
x 6.00
x 6.00
x 6.00
x 6.00
x 6.00
x 6.00
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
SUBTOTAL
$
PLUS: PROCESSING FEE
+
.00
J
EQUALS: TOTAL PERMIT
FEE DUE
=.1:i4
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675