1989, 07-20 Permit App: 89002329 Residence, J
SPOKANE COUNTY DEPARTMENT OF BUILDING AND SAFETY
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
1 certify that I have examined this permit and state that the information contained in it and submitted by me or my agent to compile said permit is true and correct. In
addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE provisions included herein and agree to comply with same. All provisions of laws
and ordinances governing this type of work will be complied with whether specified herein or not. I understand that the issuance of this permit and any subsequent
inspection approvals or Certificates of Occupancy shall not be construed to give authority to violate or cancel the provisions of any state or local law regulating
construction, or as a warranty of conformance with the provisions of any state or local laws regulating construction.
SIGNATURE OF APPLICATION
OWNER OR AGENT DATE
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Spokane County ifger-,5 F/e OAR
DEPARTMENT OF BUILDING & SAFETY
A Division of Public Works
5V ei,- q -s- v
INFORMATION WORKSHEET
b 7 -z-
PARCEL NUMBER: D5 4,/ y - / P % h/ J-�
STREET ADDRESS: 16 44 2 � ge7l,
CITY/STATE/ZIP:
SUBDIVISION:: �� n�n��pS�1 1' cas L� 4 b
BLOCK: LOT: Z_ ZONE. -A& DISTRICT:
LOT AREA:/ p F/A: WIDTH: ;=7 DEPTH: R/W: /D '
# OF BUILDINGS: # OF DWELLINGS: WATER DISTRICT: n l3
OWNER: 5 PHONE: - -
MAILING ADDRESS: 4 gay ! I S ► ti
CITY/STATE/ZIP: S rte,, 1, , _ �-
CONTACT: li;�o L.,-), Y -Q �e ,,,, I i-) PHONE:
SETBACKS: - FRONT: a LEFT: Z R RIGHT: REAR:
PERMIT USE:k2S f *10-t
BIIILDING INFORMATION
CONTRACTOR LICENSE NUMBER:
CONTRACTOR: PHONE: - -
MAILING ADDRESS:
ARCHITECT/ENGINEER: PHONE: - -
MAILING ADDRESS:
NEW: REMODEL: ADDITION: CHANGE OF USE:
DWELL UNITS: OCCUPANT LOAD: BIIILDING HGT: STORIES:
BIIILDING DIMENSIONS: % (WIDTH % DEPTH) SQ. FT.:
REQUIRED PARKING: # HANDICAP: SEWER (Y/N): HYDRANT:
MECHANICAL PERMUT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS:
CITY/STATE/ZIP: PARCEL NUMBER:
OWNER: PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State)
CONTRACTOR: LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT
(Zip)
(Zip)
= AMOUNT
DUCTWORK SYSTEM_ _ _ _ _ _ _ _ _ _ _ _ _
WOODSTOVE/INSERT _ _ _ _ _ _ _ _ _ _ _
GAS WATER HEATER _ _ _ _ _ _ _ _ _ _ _ _
HEATING EQUIPMENT <100,000 BTU _ _ _ _
HEATING EQUIPMENT +100,000 BTU _ _ _ _
GAS PIPING (1 - 4 OUTLETS) _ _ _ _ _ _ _
GAS PIING (5 OR MORE. EACH:)_ _ _ _ _ _
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU_ _ _ _ _ _ _ _ _ _ _
REFRIG 501-1,000M BTU_ _ _ _ _ _ _ _ _ _
REFRIG 1,001-1,750M BTU_ _ _ _ _ _ _ _ _
REFRIG +1,750M BTU _ _ _ _ _ _ _ _ _ _ _
HEAT PUMP & AIR CONDITIONER 0-3 TONS _ _
HEAT PUMP & AIR CONDITIONER 3-15 TONS _
HEAT PUMP & AIR CONDITIONER 15-30 TONS _
HEAT PUMP & AIR CONDITIONER 30-50 TONS _
HEAT PUMP & AIR CONDITIONER +50 TONS _ _
VENTILATING FANS _ _ _ _ _ _ _ _ _ _ _ _
EVAPORATIVE COOLERS_ _ _ _ _ _ _ _ _ _ _
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD _ _ _ _ _ _ _ _ _ _ _ _ _ _
CLOTHES DRYER_ _ _ _ _ _ _ _ _ _ _ _ _ _
RANGE_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
GAS LOG_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
MISCELLANEOUS (NOT COVERED ELSEWHERE)_ _
UNLISTED GAS APPLIANCE <400,000 BTU_ _ _
UNLISTED GAS APPLIANCE >400,000 BTU_ _ _
USED APPLIANCE <400,000 BTU_ _ _ _ _ _ _
USED APPLIANCE >400,000 BTU_ _ _ _ _ _ _
AIR HANDLER <10,000 CFM _ _ _ _ _ _ _ _
AIR HANDLER >10,000 CFM
x$10.00
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x
x100.00
x
x100.00
x
x
=
25.00 =
10.00 =
12.00 =
15.00 =
4.00 =
1.00 =
12.00 =
20.00
25.00
35.00 =
60.00 =
12.00 =
20.00 =
25.00 =
35.00 =
60.00 =
10.00 =
10.00 =
50.00 =
10.00 =
10.00 =
10.00 =
10.00 =
10.00 =
50.00 =
=
50.00 =
=
12.00 =
15.00 =
%?
_
SUBTOTAL $
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT
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
PLUMBING PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS:
CITY/STATE/-JIP:- 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
NUMBER OF I X EACH I
I FIXTURES (FIXTURE I = AMOUNT I
TOILETS
I � Ix
$6.00 =I I
SINKS
( i Ix
6.00 =I I
SHOWERS
I [ Ix
6.00 =I I
BATH TUBS
I Ix
6.00 =I I
KITCHEN SINKS
I Ix
6.00 =I I
DISH WASHERS
I
6.00 =I
GARBAGE DISPOSAL
—_Ix
I Ix
6.00 =I
CLOTHES WASHER
I Ix
6.00 =I
UTILITY SINKS
I r' Ix
6.00 =I
ELECTRIC WATER HEATERS
I Ix
6.00 =I
FLOOR DRAINS
I Ix
6.00 =I
FLOOR SINKS
I Ix
6.00 =I I
BAR SINKS
I Ix
6.00 =I I
ROOF DRAINS
I Ix
6.00 =I I
LAWN SPRINKLER
I Ix
6.00 =I I
SEWAGE EJECTOR
I Ix
6.00 =I I
WATER SOFTENER
I Ix
6.00 =I I
URINAL
I Ix
6.00 =I I
DRINKING FOUNTAIN
I Ix
6.00 =I I
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
ISUBTOTAL I $
(PLUS: PROCESSING FEET+ $ 25.00 I
I
(EQUALS: TOTAL PERMITI I
I FEE DUE I= $ I
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 9-9260 (509) 456-3675
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1 RANSAMER.ICA TI*I-LE IF!SMNCE CO?APt 1 i
NORTH 720 ARGONNE ROAD
SPOKANE, WA. 99206
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This print is made solely for the purpose of assisting
In locating said premi1�es a:0 the company Assumes to
t liability for variatiu�;. it any, in dimensions and
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