1992, 05-26 Permit App 92003700 FurnaceMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: ,1755/
CITY/STATE/ZIP: _20(C a/Pf-
OWNER: l5i//
MAILING ADDRESS: >.--14/7C
(Street)
• CONTRACTOR:
MAILING ADDRESS: ADDRESS: 3
PARCEL NUMBER:
PHONE NUMBER:
(City/State)
LICENSE NUMBER:
PHONE NUMBER:
(Zip)
C
DESCRIPTION
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
. ,
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA 01
. .
. .
• • • •
BOILER/REFRIG 1-100M BTU
.........
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG +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 <40.0,000 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 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 =
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:
(Zip)
(Street)
(City/State)
PLUMBING WORKSHEET/FEE SCHEDULE
DESCRIPTION
TOILETS
SHOWERS
KITCHEN SINKS
:.......:.:.::.::.:..::....:...........................
GARBAGE DISPOSAL
UTILITY SINKS
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 =
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 =
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