1992, 02-13 Permit App 92000809 Gas Piping':1f, JT PURE
DESCRIPTION
Olo-5- LAS
0C..12553'
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
.IO11 STREET ADDRESS: 3516 North Flora Road
r ►TY/STATE/ZIP: Spoaken WA 99216 PARCEL NUMBER:
c wNIER : Randy Puckett
PHONE NUMBER: (509) 926-8433
MAILING ADDRESS: 3516 North Flora Road Spokane, WA 99216
(Street) (City/State) (Zip)
CONTRACTOR: Steinmetz Heating & A/C
LICENSE NUMBER: STEINHA147KF
PHONE NUMBER: (509) 922-2034
MAILING ADDRESS: 2114 North Pines Road, Suite 3 Spokane, WA 99206
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DUCTWORK SYSTEM
WOODSTOI4E/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (EA OUTLET)
REFRIG 1-100M BTU .(NOT A/C OR HEAT PUMP)
I;I:FRIG 101-500M BTU
RIEI•'RIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
Iz1;FRIG +1, 750M BTU
(FEAT PUMP & AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT EAT PUMP & AIR CONDITIONER 15-30 TONS _
HEAT PUMP & AIR CONDITIONER 30-50 TONS _
(FEAT PUMP & AIR CONDITIONER +50 TONS
VI.:NTILATING FANS
EVAPORATIVE COOLERS
TYPE I ROOD (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
u:;Ell APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR FFANDLER >10,000 CFM
1
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 1.00 =
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 =
= AMOUNT I
1.00
NOTE: MINIMUM PERMIT FEE IS $35.00
CK #3638
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
SUBTOTAL S 1.00
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
FEE DUE
+ $ 25.00
$ 35.00
JOB STREET ADDRESS:
CITY/STATE/'LIP:
OWNER:
MAILING ADDRESS:
CONTRACTOR:
MAILING ADDRESS:
PLUMBING PERMIT APPLICATION FORM
Information Worksheet
(Street)
(Street)
PARCEL NUMBER:
PHONE NUMBER:
(City/State) (Zip)
LICENSE NUMBER:
PHONE NUMBER:
(City/State) (Zip)
PLUMBING WORKSHEET/FEE SCHEDULE
J -- DESCRIPTION
TOILETS
SINKS:
SHOWERS." _
BATH ..TUBS
KITCHEN, 'SINKS.--:
DISH WASHERS
GARBAGE DISPOSAL"':_'
CLOTHES'WASHER
UTILITY SINKS
ELECTRIC WATER HEATERS
FLOOR DRAINS
FLOOR SINKS
BAR SINKS
ROOF DRAINS
LAWN SPRINKLER
SEWAGE EJECTOR
WATER SOFTENER
URINAL
DRINKING FOUNTAIN
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATUR
[NUMBER OF I X EACH I I
FIXTURES (FIXTURE I = AMOUNT.
I Ix $6.00 =I
Ix 6.00
I Ix 6.00
I Ix. 6.00
Ix: 6.00 =[ I
I Ix 6.00 =[
Ix 6.00
Ix 6.00 =[ I
I Ix 6.00 =I I
I Ix 6.00 =I I
I [x 6.00 =I I
Ix 6.00 =I I
Ix 6.00 =I I
Ix 6.00 =I I
[x 6.00 =I I
I Ix 6.00 =[ I
I Ix 6.00 =I I
I [x 6.00 =I I
Ix 6.00 =I I
(SUBTOTAL I $ I
t i i
i
PLUS: PROCESSING FEET+ $ 25.00 I
I I
(EQUALS: TOTAL PERMITI I
I FEE DUE I= $ I
t � i
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, V, n0160 (509) 456-3675