1992, 03-11 Permit App 92001438 Furnace, Dryer, Joist AlterationMECHANICAL PERMIT APPLICATION FORM
Information 'iTiorksiieet
JOB STREET ADDRESS: E. 7?.=2..C. 04?._ cksc v
CITY/STATE/ZIP: Sj000 /Ca.pi Ria , 91.-Z4.2 PARCEL NUMBER:
OWNER: no pie:L/6Z12, Ale /46. ey,7 PHONE NUMBER:
MAILING ADDRESS: ,--Cct...vr) e_
(Street) (City/State)
CONTRACTOR: LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(Zip)
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
.ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
i:W000Slb.Vtligt77
GAS WATER HEATER
GAS EQUIPMENT +100,0.00 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
.......
BOILER/REFRIG 1-100M BTU
„.,
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,0001-1 ,750M BTU
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
. . .
HEAT PUMP & AIR CONDITIONER 30-50 TONS
VENTILATING FANS
. • ••••• ••
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
RANGE
GAS LOG
UNLISTED GAS APPLIANCE <400,000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x too =
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 =
I
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
PLUMBING PERMIT APPLICATION 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
DESCRIPTION
TOILETS
SHOWERS
B'. THTUBS'
KITCHEN SINKS
GARBAGE DISPOSAL
C'OTHES WASHER€<
UTILITY SINKS
ELECTRIC
FLOOR DRAINS
QR> T
BAR SINKS
FDRAIN'S'»'>>`»>>»>'>>>>€ [> >«<><>I
;:.::...:
LAWN SPRINKLER — FOR EACH BACKFLOW DEVICE
SEWAGE EJECTL
WATER SOFTENER
....................
URINAL
.....................
....................
.....................
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 =
x6.00 =
x 6.00 =
x 6.00 =
x6.00 =
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