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1993, 05-03 Permit App: 93003111 Plumbing Fixtures (_/ PLUMBING PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: -.3® g it ., i�' , V a /17 aC'f�h CITY/STAT IP: k h CO-a- �7�vC PARCEL NUMBER: IN /�/c OWNER: o''....- PHONE NUMBER: 1�G " !`64P,s- li / �rl�� MAILING ADD ESS: 6-0 SC Yom`"_ �'-'�`Q� LI /C ia-� , ( i (Street) (City/State) (Zip) CONTRACTOR: LICENSE NUMBER: �j PHONE NUMBER: l� MAILING ADDRESS: � !State) CSP) (Street) (City PLUMBING WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNTl'6.-j x6.00 = a -.0. . J TOILETSt �.. ,:�<��..�..:IOW: ,r,� / x 6.00 6 .�C-' t> n} �� . �:.:.::}::}::}:>:-:. x 6.00 = SHOWERS �/ x 6.00 yy.:�.y..q;}. o• x-;rb'c�ki} 's.,�,i�`�G: 25ii`• — 6 .0 c 0,) l,41/1_;t:;l s:'>t'-�y WWWa}.W:f"•.:+t3Y: V :av' }. •�`: iv:r h:*. w:'^t`.l.•f:'r i}aJ#i:�... = KITCHEN SINKS x 6.00 �, .�..,,�::,;,�t: ::::«¢ ,�"� �� x 6.00 = S ..'tiAGE DI x 6.00 = �. e� GARBAGE DISPOSAL WOW x 6.00 \\\\VVV ky:;a}1i�w� MC -0} r Ji 4$,. >' ' }tY.k!: :h:�SY Y i4p>'L,x. — ��M�•4'i'Jl�� :.:$•.•: •i:.':.4i0kkM:J:G'. .tik�v:$.•�+:}:'::}n:}:ti.'•.•: :}<:titii:<•:�:i}:}:•:•}:�:::,:::>..•ka.�},,;,�. x 6.00 = UTILITY_ SINKS •., ;;�,..} >,> {:} '{+ik x 6:00 = ��, :.;:}}: .}:�i.:�xx�«k�so-w. : FLOOR DRAINS x 6.00 = �- Tt., Ar x6.00 = €::°:v�k:: :<:>h�ri:; :.'.:,. • � x 6.00 = BAR SINKS <:•: M Q �1 O E.. . ' ` .ice . ' x6.00 = LAWN SPRINKLER—FOR EACH BACKFLOW DEVICE x 6.00 = �YFM , X6.00 = 2�i. a.»:a��h••f ,•: yf{ o i` ,� ' is..^y rk-0;••- — :}x:k.:::o}+•>}7hi}:a::Sswr 9wkcda i - WATER SOFTENER + ri x 6.00 = �3'Rfi } . $i :-w ": .tt• -� r. r: � ,r, x 6.00 = :::.:::.:::.:::.:::...::.:::.:::.:::&.:..4:..:4& ` . }.&.'A h ,•*•:.S?�i*. OYttSG , DRINKING FOUNTAIN x 6.00 = SUBTOTAL $ PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS:TOTALPERMIT FEE DUE =$ ...... SIGNATURE �� a ci7 ..,. Spokane County Division of Buildings . .. . _-_ .•i e Armen ICACI% .1 gR_4R7R 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 ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = - - •'y`y' (�/�/��Myy <. `' ?.t•�.:}:i:} ••f ' .}a'`''.A-;: x 25.00 = : vv?vu•.vu4'rn`v�C•.3vh'vw.uv.....S+i.4viW..vi...............w...:...u......•:tiiv...... .•::hv:.vvv::::.v:nv•.v:nv:v.••.vr.-.. v.... ............... ..... ...... ...... GAS WATER HEATER x 10.00 = �.}•:.}v.:-•.:j::. } {.Fv py: f {rvy:n�vrrvv}w::xr:r::nvnr :ryr. •y�y rny,{;w ;; ,. L IPIti RERO i. y :{ .:`�� x 12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = $.;::: r:.:;•yvyu:;s:::.Jv:•:.•mv.:vvw fx::. wxr{g{.• •rid: :.;;:.,v,{{.}•:yxvn •{:::::. !° < f?1l C( ;M'!' :<;NNN �.': x 1.00 = BOILER/REFRIG 1-100M BTU x 12.00 = . ; # f >E:R ,' Ifs.,. h.4:WWn i.;;<.. :: .`. h•.}', x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = aggefi I `r:`� x 35.00 = :ry.:uvx:.::.r..r}r...v:.wr:..tt+.r •A�1'�v�CrA�r.J.rmfLvvL0.invY.v:LMv{H •RL. ..Y.{vr �`'Ca{ BOILER/REFRIG +1,750M BTU x 60.00 = gneA :: P ` `I` MFAVO;V:aids x 12.00 = HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 = f•'0 vv7 M'vi}. Y }v'•v }�ytY��yvyv�}wy�ww{n/!yn�►{}�, ;v,by }H `'%i?11�M ' }t� nvC 1; f ' ::. IM::•Yn� 7K Jam:• l x 25.00 = HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 = < FRMA ; uvL NI Swfnw , x 60.00 = VENTILATING FANS I x 10.00 = :fn :.wN1rK^..wa f:j: :.v}••.�.:•:fi:.vr �vr. $ QRkCO f{ :;;rv. x 10.00 = TYPE IuHOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = . PIt • rvS "alw\ej x 10.00 = CLOTHES DRYER x 10.00 = /x::•;••_:':�7x•:.•;.'•:',�'ny 1 vY.vf `;'j�:;;_;;;y;`."•�F`ry:dry r. �}?`•{: r}'`�`' t''• x 10.00 = GAS LOG _ _ x 10.00 = MIC C E 'i E1 t"1 ''`)C rf3V< X l C , x 10.00 = {?v};.ri•.vyvuu-ivuyMKv:uu<iv.n.Wt•\v$vh uYmi{wivv�viLYirv' :-.i�:uBi�W.A{�•i .l UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = „�vr.:f•..,:.}vx:..vv .n;::n;:..yv.}• ` \ r;::ii�::-'h.<S}.{;.I �ti x100.00= ,Cr}.I�SxT�.}77;:}C.�..,•.#��} ��Ii �P;r;M:: , ,n:'::��:�.:,�°:�<}:{� USED APPLIANCE<400,000 BTU x 50.00 = Z:yy...y:::r:.:r�:.;.r.,::.•?:..:;:.7::.yy:A:.:.•;�y;:.}•.wr:,w.<w.;Nr.4::::.•:.�i„xf:.::�•``r:x:}:a::.}::{;?{{xy}'::G:`::..tir•.;;.;{:; r:::::. Si* i A 11 t/if`1Gi� I } .:: .: :•:. •, ..... f :/�{}:: `' f:{:p3?fij��{??%S ffi'y}v+r F',+�,C+rf' v}}:i x100.00= :v ......... ..nv:..r .u.:.v..}xr�•:fixr}.•.vi .vxn nvu}::?v�fr::: •%?fi}}:}:v:•}:v::::ff v.v......:7}:y.•: •:}i:?•}:ti}. AIR HANDLER<10,000 CFM x 12.00 = 3.}•{.::::.;{:.;;:{..;.;•.}.f:{::;::.:::.}}:+,,fi}•...{{�;,�};:{{r..�yr.,,.:•r:{y:,•.;:�iG9'r%:�:::"•.:i?%+ :;::•`-'`;•"?%'}2,v'r'r'�:2�?�C;<2�c<..",.�: AfBNFC, ` 1Q1V: <°:>xv. srf'<<<.. :..'.'': x 15.00 = SUBTOTAL $ PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS:TOTAL PERMIT FEE DUE _$ SIGNATURE Spokane County Division of Buildings