1992, 08-03 Permit App: 92005967 Furnace, Piping MECHANICAL PERMIT APPLICATION FORM A oed L/2/
Information Worksheet 14-
JOB STREET ADDRESS: 3 . 1-7//()c-
CITY/STATE/ZIP: ‘5-p(_)1(1 706 PARCEL NUMBER: LIG Tz_4- O /
OWNER: PHONE NUMBER: QZ6 9 Z.5-1
MAILING ADDRESS: c/7- - -
(Street) (City/State) (Zip)
CONTRACTOR: /t/ 7:c971-4g._ 17/1144A--.1/". LICENSE NUMBER: 4/1,51-770
PHONE NUMBER:
MAILING ADDRESS: (77.- ?-P•( L9-1-D (-2/1'7 i 2'c
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT = AMOUNT
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 =
WOOD STOVE/INSERT . x 25.00 =
GAS WATER HEATER x10.00 =
GAS EQUIPMENT<100,000 BTU (INCLUDES / x 12.00 =
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
sAVpiPiNGIEICOUTEETVER;::.;mummi: immonmgo x 1.00 =
BOILER/REFRIG 1-100M BTU x 12.00 =
„•••........••••...•••-•-•••.„•••••••••„--•„--•
x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
BOILER/REFRIG x 35.00 =
BOILER/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 =
.......... ....
H .A7,revt.op2.$:i::.-NRicoNpyroNeRi:4•WTQN$ME:::i.iimon 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 IIHOOD
x1000 =
CLOTHES DRYER x 10.00 =
RANGE x1000 =
GAS LOG x 10.00 =
MISCELLANEOUS (NOT x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINSTED GAS APPLIANCE>400,000 BTU ..: .: xi 00.00 =
USED APPLIANCE<400,000 BTU x 50.00 =
tMED::,1APPLIANce5,400"ooatcrug",""",",",,,,"",!,""""",""",""""","""N"""",","""","""" xl 00.00 =
AIR HANDLER<10,000 CFM x 12.00 =
x 15.00 =
SUBTOTAL
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE $
( Q.,
SIGNATURE • 0
.` N.-- •
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PLUMBING PERMIT APP*ICATION 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)
PLUMBING WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT = 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 =
.CLOTH
E 'R
x 6.00 =
NY.
S ACHE
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 =
x =
R IN
6 00
ROOF A
S
LAWN SPRINKLER - FOR EACH BACKFLOW DEVICE 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
NOTE: MINIMUM PERMIT FEE IS $35.00 EQUALS: TOTAL PERMIT
FEE DUE = $
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675