1992, 08-25 Permit App 92006818 Wtr HtrMECHANICAL PERMIT APPLICATION FORM 92- /c9
Information Worksheet
JOB STREET ADDRESS: S L-Cr4 14 2 3s D R I Co D I� l
CITY/STATE/ZIP: DKA-N plN1 ti . q 9 2. U 142 PARCEL NUMBER: LA3PS.O,0
OWNER: 7z J k ei_LEk PHONE NUMBER: 9 2.'z - 5'7 3
MAILING ADDRESS: -s/m
(Street) (City/State) (Zip)
CONTRACTOR: No cvEsi fiEA- rN6 At r LICENSE NUMBER: A/W RE F 14C:lb 93-7
PHONE NUMBER:
MAILING ADDRESS:-Pd�Zfraqu •e- a / 134-179 4oK n%- r vL'
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
V1+ DST=>.EIfNS
V
S 0.;::ER'%`:::::<>::>::;:;::.;;;:.;::.;:;.;::.:>:::::;'<::::;.,:::::::
GAS WATER HEATER
GAS EQUIPMENT +100,000 BTU DUCTWORK)
'h'Y'tV`i•�1'itiil t'I1.1f+:L'�::Alf4�+:Y++Y.k _.__.................
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 501-1,000M BTU
BOILER!IREFRIG ,0001 1> 750M
BOILER/REFRIG +1,750M BTU
•EAT PUMP & AIR CONI ITIONER 0-3:TOWS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
.I:tH1;Y;.;::VMt'if[AIj{ CII?Ili:J1IVNtH1S- .U;i:UN
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEA U:MP>8_ AIR :ONDITIONER
VENTILATING FANS:.:::.............................................................
............................................................
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
................:
GAS LOG
JS< (NQCOVEREDEL
UNLISTED GAS APPLIANCE <400,000 BTU
USED APPLIANCE <400
USED APPLIANCE=>a00`0:00 ;,000 BTU
•
AIR HANDLER <10,000 CFM
AIR<F' A: IDLER ' :` 00 < FNt
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 =
x 1.00 =
x 12.00 =
x 20.00 =
x25.00 =
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 =
i
/6-00
SUBTOTAL
$ / 0 -0 0
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ - . ,00
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
PLUMBING PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS:
CITY/STATE/ZIP: PARCEL NUMBER:
OWNER: PHONE NUMBER:
MAILING ADDRESS:
(Street) (CitylState) (Zip)
CONTRACTOR: LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(Street)
(City/State)
(Zip)
PLUMBING WORKSHEET/FEE SCHEDULE
DESCRIPTION
TOILETS
SHOWERS
KITCHEN SINKS
DI'S;H .ASHEI
.....:..:.::.::..:
GARBAGE DISPOSAL
HER
UTILITY SINKS
ELECTRIG;WATERHT:..�:.;.;:
.....:..::..:..::.::.::.::.
FLOOR DRAINS
•
.......... ..
BAR SINKS
LAWN SPRINKLER — FOR EACH BACKFLOW DEVICE
WATER SOFTENER
URN..
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 =
x 6.00 =
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