Loading...
1992, 10-14 Permit App: 92008889 Gas Log, PipingMECHANICAL PERMIT APPLICATION FORM • In'formation Worksheet JOB STREET ADDRESS: F.: 2(.. 1 (a CITY/STATE/ZIP: 6-)rk_Ari-e.._.. \A/ A 9. _,L. OWNER: c, 16 e..t•L C • 13 r;e,r)‹.y MAILING ADDRESS: 26 tqc)c, (Street) CONTRACTOR: Re-_ rms MAILING ADDRESS: PARCEL NUMBER: PHONE NUMBER: ,5-.2) 5, - / WA- /(City/State) (Zip) LICENSE NUMBER: Ti 5 Fi2H 4.52 PHONE NUMBER: 1/ 41 - CONTRACTOR: A (Street) ( /State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) GAS WATER HEATER GAS•• GAS EQUIPMENT +100,9.0...9...FVGAS P1PING(EAQUTLE):mw........inwi..72ammin BOILER/REFRIG 1-100M BTU tomeRtfleFRIG":: ,•• . , $:3E.AIt,ILMIKONIM BOILER/REFRIG 501-1,000M BTU - BOILER/REFRIG +1 BTU e , HEAT PUMP & AIR CONDITIONER 3-15 TONS 4tr ."' - • • • HEAT PUMP, AIR CONDITIONER 30-50 TONS ATPUMP• e,e7ggirgr:Mankii. VENTILATING FANS VAPORAVjLRS TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) UHOOI • • . • • • • • • CLOTHES DRYER GAS LOG UNLISTED GAS APPLIANCE <400.000 BTU USED APPLIANCE <400,000 BTU AIR HANDLER <10,000 CFM • NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE Sp West 1303 Broadway - NUMBER OF UNITS X EACH UNIT = AMOUNT x10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x 1.00 = x 12.00 = x20.00 = x25.00 = x35.00 = x 60.00 = x 12.00 = x20.00 = x25.00 = x 35.00 = x 60.00 = x10.00 = x10.00 = x 50.00 = x10.00 = x10.00 = x10.00 = x 10.00 = x10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = 4 . • ,-: : SUBTOTAL $ PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =$ unty Division of Buildings e Spokane. WA 99260 (5091456-3675