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1992, 12-02 Permit App 92010537 Furnace
MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: g /CgO 5 ,,20, ,?) &)4� CITY/STATE/ZIP: I/F A 7A4GL PARCEL NUMBER: OWNER: f',4lJ6 .l /14,E 4410GNOZ)2 PHONE NUMBER: Y7,‘" SZ63 MAILING ADDRESS: 5,4A/1 (Street) (City/State) CONTRACTOR: LICENSE NUMBER: PHONE NUMBER: MAILING ADDRESS: (Zip) (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) itIv i \}ivv::ii?:.y;Y{;'.,:j }4':.i: SXyj: GAS WATER HEATER GAS EQUIPMENT +100,000 BTU DUCTWORK) yffyyy,11.., v,•{1:?: `4 v\iS$: ?;:vY'4?: •.11!A•�:il��l�!I�r!'.}.{�Y.':1:�.::k;{i4:}�?:i�{i:\ir\C>:/Y.i.1, 4ii{{.\i}:}i:�::i :i:: ..,vx.w:::r::::::\•.{:?•.,w.v:�»Mv.,{•xF.w{w:v.+� ..., r..:.:W „4::.,,�•�3:.h:.v: \nV: n,v. BOILER/REFRIG 1-100M BTU •. �%�j%�y�M:`q: :�;3?f••:.ti:.;.y::. .. .. . ,,v}:. ,y:;• :.}. n'✓:iia'i: •a `v.,v...:.:. a .nv:::.v: v,vvx C:: `.w •: :'• vvw• .. BOILER/REFRIG 501-1,000M BTU �vu BOILER/REFR_IG +1,750M BTU 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 GAS LOG UNLISTED GAS APPLIANCE <400,000 BTU USED APPLIANCE <400,000 BTU : :rn:re�•zx: e:r:e�a :•-r:c� r:rrrr�s z<:: x:,w;} ..................... AIR HANDLER <10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE a/..0 (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 = x20.00 = x 25.00 = x 35.00 = x60.00 = x 12.00 = x20.00 = x25.00 = x35.00 = x _ 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) (ZP) DESCRIPTION TOI LETS SHOWERS KITCHEN SINKS GARBAGE DISPOSAL UTILITY SINKS FLOOR DRAINS BAR SINKSf PLUMBING WORKSHEETIFEE SCHEDULE 1r `>::.�itL'C${i {}:i - - - - J\:iL:::v.:-::i40T:•:{iii5}<i �nS:Ciw�iv: LAWN SPRINKLER — FOR EACH BACKFLOW DEVICE WATER SOFTENER 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 = x6.00 = x 6.00 = x6.00= x 6.00 = x6.00 = x 6.00 = x6.00 = x6.00 = 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