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1993, 06-08 Permit App: 93004517 Water Heater, Piping
3512'-I. 00°3 MECHANICAL PERMIT APPLICATION FORM -- pt55,eSoe3 puNT Information Worksheet JOB STREET ADDRESS: Z37 N Dradity CITY/STATE/ZIP: --Y;b10nE. 1 A • ?2' 7 PARCEL NUMBER: OWNER:, ko; ./4e-cd/n6 MAILING ADDRESS: PHONE NUMBER: 9z 4- ay 7 y (Street) CONTRACTOR: MAILING ADDRESS: F iito,2, MCLS (Street) DESCRIPTION (City/State) LICENSE NUMBER: PHONE NUMBER: 5-69 - (Zip) WV" T E r - ss -co 0 (Zip) -PdX (CIty/State) MECHANICAL WORKSHEET/FEE SCHEDULE ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOY)iNSE GAS WATER HEATER GAS :duip:mtot.ftio:00!:tifol(oc407""7. GAS EQUIPMENT +100,000 BTU DUCTWORK) GAS PIPIt'G (A ..... BOILER/REFRIG 1-100M BTU tEjoillERMEFFIWI0fg6.00K TU BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG +1,750M BTU ffEATip.om04:Atoi:..CoNibifioNtft .... . ..... . .... . . .. . . .. 0-3 TONS ................... HEAT PUMP & AIR CONDITIONER 3-15 TONS - - i.opkritypircAgi:0000itioNtkTe7:7"--"::'''",* CONDITIONERHEAT PUMP & AIR idkdHAT PUMP & AIF CONDFflONER +50 TOS VENTILATING Af,i VAPORATIVE • • • • .......... TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) • CLOTHES DRYER 0-41.\4 • GAS LOG UNLISTED GAS APPLIANCE <400,000 BTU ULft4STtD GAS APPL1ANC>400000 BTU _ USED APPLIANCE <400,000 BTU USED APPLIANC >400000 TU ,,, AIR HANDLEF( .. 6,6066 CFM _ : - - CODE ENFORCEME -NOTE MINIMUM PERMIT FEE IS $35.00 • NUMBER OF UNITS X EACH UNIT = AMOUNT x10.00 = x 25.00 = x 10..00 = x 12.6d = x15.00 = x 1.00 = x12.00 = x 20.00 = x 25.00 = x35.00 112 x 60.00 = x12.00 = x 20.00 = x 25.00 = x35.00 X 60.00 x10.00 = x10.00 =1 x 50.00 = x10.00 = x10.00 = x10.00 1= x10.00 = x10.00 = x 50.00 x100.00 = x 50.004•_::7-.•ai) x100.00 = x 12.00 = x 15.00 = /67. a o / • - - - _ - =';7•1=1_.. -•-', 7: : r',, ---_-,1_-_ --.--...,--:--;---7-----,i: SUBTOTAL _ _. °° $ flOO PLUS: PROCESSING FEE + $ 25.00 'EQUALS: TOTAL PERMIT - FEE DUE • PPL3 :I or'lii = $3 • - z, Spokane County Division of Buildings - _ --West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 West 12( SiC-NATURE. .4_ • err s !1111 '