1993, 04-08 Permit App: 93002244 Wood StoveMECHANICAL PERMIT APPLICATION FORM
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JOB STREET ADDR SS: i.1O\,
CITY/STATE/ZIP: V ' ??C3 PARCEL NUMBER:
OWNER: D 1 \(/ �i .(.t� LQh PHONE NUMBER: 9,26-04151
13-)-)0
:
MAILING ADDRESS:
(Street) ,
CONTRACTOR: Er - )Cr, C r3 r2ur i.1 CFi.I f F,2
MAILING ADDRESS: E. c] 31 n �}O QA,91,( P.
(Street)
DESCRIPTION
(City/State) (Zip)
LICENSE NUMBER: rt4IC-O &&C f 73 bLi(
PHONE NUMBER: (406 1) ci.2b-g9/)
MECHANICAL WORK
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
GASEQl1,IPMENT<10:0 3Tll_NCDES>
GAS EQUIPMENT+100,000 BTU DUCTWORK)
.GAS: PIPING (E OUT
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 501-1,000M BTU
BOO FAIRE RIG:<
BOILER/REFRIG +1,750M BTU- -`=
11 F'I' pUMP B AIR: CONDIT O1 _Ff3 0-3 TONS'....--
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEA3`PUMP SAIR.CO•NDIT1ON."_- ••• •••••
HEAT PUMP & AIR CONDITIONER 30-50 TONS -
HPlitiAP_B�xAIEt_GONtQN •
VENTILATING FANS
>EYAP.ORAT1VE>i
TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD)
•
CLOTHES DRYER
GAS LOG
:::.:.. ...........
.................
MISCELLANEOUS (NOTCOVERED ELSEWHER`.
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED,GAS-APPLIANCE>400000
USED APPLIANCE <400,000 BTU
...........
USED::AP.PLIANCE>400 000;:=8
..................................................:..
AIR HANDLER <10,000 CFM
'AI HANDLER:>10 000.:CFIi�1:>
NOTE MINIMUM PERMIT FEE IS $35.00
SIGNATURE
9920%0
(City/State) (gyp)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
1
x 25.00 =
O
x 10.00 =
x 12.00 =
x 15.00 =
x1.00 =
..
x12.00 =-
-
x 20.00 =
: -
x25.00 =
• .-_
x 35.00 =
x 60.00 =
x12.00==
x 20.00 =
x 25.00 =
x35.00 =
x 60.00 =
x 10.00 =
x10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x10.00 =
x 10.00 =
x 10.00 =
. .
_-.-
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
jSUBTOTAL
$ 25cO
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ 60.a)
Spokane County Division of Buildings