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1993, 06-01 Permit App: 93004162 Water Heater, PipingqsaAno MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: /2a 1 sRob /L5A CITY/STATE/ZIP: k,ekk_e OWN ER: MAILING ADDRESS: CONTRACTOR:in(dq-noi MAILING ADDRESS: DESCRIPTION PARCEL NUMBER: PHONE NUMBER: (Street) (City/State) Olu /12,4-14:An W24-eLICENSE NUMBER: 11A) L-64 PHONE NUMBER: .53V-- 9700 35-06. 'site citric .5to7CA-etsa Ceja (Street) (City/State) (Zip) 11c?cv MECHANICAL WORK ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOVE/INSERT GAS WATER HEATER AS!itOLIIPMAEMP'00004i1317PAISM9PaSINEum GAS EQUIPMENT +100,000 BTU DUCTWORK) 441gigifigkg*MICOINSIEREMilleigionse, BOILER/REFRIG 1-100M BTU ObitajffittiMitibt-SOMITOMEgoomnsiongEN BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG 1,0001-1,750M BOILER/REFRIG +1,750M BTU HEAT otiao*4ti147 CoNattibREtk,itgli:TioNSERNINii: HEAT PUMP & AIR CONDITIONER 3-15 TONS ig,Atmo.volaArikkiblitifiti001;111641410useenii HEAT PUMP & AIR CONDITIONER 30-50 TONS tiWAS:it0)0iitiiWatoicitgivgtogo34.04Valligimi VENTILATING FANS EVAPORATIVE COOLERS TYPE I HOOD (PER 12' OR 12' PlN: OF HOOD) INSRiffaSaniiiiMiiitatlieligGEMMINEESE CLOTHES DRYER iiRANGE1:41:1:,!:::,SAZ:SZE:altiONC2VNESEMOZ GAS LOG limfooaatoumootitoygq(qi.g-wwsolginso UNLISTED GAS APPLIANCE <400,000 BTU iltIONISTEOIOASiiAPPLIANoe:§400101013171021Miumffil USED APPLIANCE <400,000 BTU USED APPLIANCE >400,000 BTU AIR HANDLER <10,000 CFM AIR HANDLER >10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE 44 - 99ao (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x10.00 = x25.00 = / x 10.00 = x 12.00 = x 15.00 = r x 1.00 = x 12.00 = x20.400 = x25.60 = x 35.00 = x 60.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x60.00 = x10.00 = x 10.00 = x 50.00 = x 10.00 = x10.00 = x10.00 = x10.00 = x10.00 = 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