1991, 10-25 Permit App: 91007224 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
76rmation Worksheet
JOB STREET ADDRESS: S' /‘//,'", a-4 c24.4:47“,,,-2,;
CITY/STATE/ZIP: S/oa4n*..c ///,. PARCEL NUMBER:
OWNER: TN,P 77647/7 PHONE NUMBER: 9,25n -5/87q
MAILING ADDRESS:
(Street) (City/State)
CONTRACTOR:/,,,,,A,, /Leyat--w LICENSE NUMBER
MAILING ADDRESS:
(Zip)
PHONE NUMBER: 4.6v R3Ac
2./l9aA/o
g38 /'/
DESCRIPTION
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
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GAS WATER HEATER
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GRS Aft lata QttM
BOILER/REFRIG 1-100M BTU
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BOILER/REF_RIG 501-1,000M BTU
gritart
BOILER/REFRIG +1,750M BTU
Intatiligaganingillatt
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
VENTILATING FANS
iglx..:.,....j:.}.yn+w�p{,Y/�y�,�<'r4^
i'Y.Sm%V,WV,.riv`.'o?,:<`5?..9$TX
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
*Pr PAKIM
UNLISTED GAS APPLIANCE <400,000 BTU
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USED APPLIANCE <400,000 BTU
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AIR HANDLER <10,000 CFM
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E:
NOTE MINIMUM PERMIT FEE IS $35.00
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x1.00 =
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 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/
/
Z
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS' TOTAL PERMIT
FEE DUE
= $
SIGNATURE�.-.7>o l�-C� -
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PLUMBING PERMIT APPLICATION FORM
Information WorkA`aet
JOB STREET ADDRESS: Sf�ll •
CITY/STATE/ZIP: PARCEL NUMBER:
OWNER: _77 --/Az 7."?.4 •,/ PHONE NUMBER: 7,23 - 5./f3 77
MAILING ADDRESS:
(Street) (CitylState) (Zip)
CONTRACTOR: ,,,,8i4 /9,665 5 /1e// LICENSE NUMBER: Co/ezi-,//0 / 1 9 / /c7
PHONE NUMBER: - g 3 8
MAILING ADDRESS:
(Street)
(CitylState)
(Zip)
PLUMBING WORKSHEET/FEE SCHEDULE
DESCRIPTION
TOILETS
SINKS
SHOWERS
........................................
BATH TUBS
...........................:...............
.......................................
KITCHEN..SINKS
.......................................
GARBAGE DISPOSAL
....................................................
xCC IfS
UTILITY SINKS
E�T#�Ir��yVA
FLOOR DRAINS
BAR SINKS.�::.-........:..:.....:................................................................................
............................
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 =
x 6.00 =
x 6.00 =
x6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
x 6.00 =
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675