1992, 02-04 Permit App 92000603 Pellet StoveMECHANICAL PERMIT I ?PLICATION FORM
Information Worksheet
G
JOB STREET ADDRESS: 1 p q\\ -c o r=1:b W }A-\k
CITY'STATEIZIP: - \ C9CeenI re.5 (n)r gyGl Le PARCEL NUMBER:
E S: CrudN -?,,eecia_i n re►9- c; 0 ca-61 ✓Yic yl
MAILING ADDRESS: C l -qi ��fpOfJ f�j
(Street)
CONTRACTOR:
PHONE NUMBER:
&re e ✓l c fe s S o/ ee
(City/State)
LICENSE NUMBER.
PHONE NUMBER:
MAILING ADDRESS:
(Zip)
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS EQUIPMENT <100,000 BTU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 101-500M 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 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 LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPUANCE <400,000 BTU
ULINSTED GAS APPUANCE >400,000 BTU
USED APPUANCE <400,000 BTU
USED APPUANCE >400,000 BTU
AIR HANDLER <10.000 CFM
AIR HANDLER >10.000 CFM
NOTE: MINIMUM '•ERMIT 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 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x25.00 =
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 =
V
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 PEPMI 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
TOI LETS
S1NKS .
SHOWERS
...................................................................
BATH :TU.BS
KITCHEN SINKS
.................................................... .........
......................................................... ..... .
DISH; WASHERS
GARBAGE DISPOSAL
................................................
C.LOTHES;WASHER
UTILITY SINKS
......................................................................
ELECTRIC WATER<HEATER
FLOOR DRAINS
BAR SINKS ;:;;; :.............................. .
..................................
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 =
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 =
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