1990, 12-05 Permit App: 90006532 Water Heater, Piping"'e ec c,ev-N . /4=
MECHANICAL PERMIT APPLICATION FORM A- // -
Information Worksheet
v ,� r a
JOB STREET ADDRESS: 5 579 ac s7e.; ye
a -3 2 /
CITY/STATE/ZIP: s,e [,,, 4 PARCEL
OWNER: /2� �fli
MAILING ADDRESS: $ _/4/ C u,e A, �c!
CONTRACTOR:
(Street)
09A/Ce-
NUMBER: ,,235'2 -3 7I 2_
PHONE NUMBER:
MAILING ADDRESS: 333c› 0.-4
(Street)
(City/State) (Zip)
LICENSE NUMBER: rf,.--TSE?C.a2 7) PX
PHONE NUMBER: 3-75-- y o0 /
sok.A.,re_ 4d4 .6v
(City/State) (Zip)
MECHANICAL
DESCRIPTION
WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS LUNIT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (EA OUTLET)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 50171,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT'PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
0-3 TONS _
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE)
UNLISTED GAS APPLIANCE <400,000 BTU
UNLISTED GAS APPLIANCE >400,000 BTU_
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM
= 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 =
12'
NOTE: MINIMU E FEE IS $35.00
SIGNATURE Ao"
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Coo
5
=$3.
Spokane County Department of Building_ and Safety
West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675