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1991, 02-20 Permit App 91000621 Wtr HtrPLUMBING PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: 11910 CCU.- - , 04 f G�45-%%- CITY/STATE/ZIP: �� �I 24 PARCEL NUMBER: n .i,<‘ OWNER: Mct J PHONE NUMBER: ! 21— / 2- MAILING ADDRESS: ;Jo, • _. �l � I a,4�� �,i_` •04, (Street) CONTRACTOR: MAILING ADDRESS: "'f ! 04' POI- (City/State) !nab (Ziip) LICENSE NUMBER: ,i V�1 PHONE NUMBER: (Street) 162 ne (City/State) (Zip) PLUMBING WORKSHEET/FEE SCHEDULE DESCRIPTION NUMBER OF FIXTURES X EACH FIXTURE = AMOUNT 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 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 = (G•CC NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE -9a6 O2IJfk SUBTOTAL PLUS: PROCESSING FEE EQUALS: TOTAL PERMIT FEE DUE $ 25.00 Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 JOB STREET ADDRESS: CITY/STATE/ZIP: OWNER: MAILING ADDRESS: CONTRACTOR: MAILING ADDRESS: MECHANICAL PERMIT APPLICATION FORM Information Worksheet (Street) PARCEL NUMBER: PHONE NUMBER: (City/State) (Zip) LICENSE NUMBER: PHONE NUMBER: (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION I OF UNITS UNIT = AMOUNT DUCTWORK SYSTEM_ _ _ _ _ _ _ _ _ _ _ _ _ WOODSTOYE/INSERT _ _ _ _ _ _ GAS WATER HEATER ------------ HEATING ________HEATING EQUIPMENT <100,000 BTU _ HEATING EQUIPMENT +100,000 BTU._ _ _ - - GAS PIPING (EA OUTLET) - _ _ _ _ _ REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP). REFRIG 101-SOOM 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 LUG 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 <16,000 CFM _ - - _ - - _ _ AIR HANDLER >10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE SUBTOTAL I $ PLUS: PROCESSING FEEI+ $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675 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. OC = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 10.00 = x 10.00 = x 50.00 = 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 = SUBTOTAL I $ PLUS: PROCESSING FEEI+ $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675