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1993, 06-15 Permit App: 93004577 Pool Heater, Piping
MECHANICAL PERMIT APPLICATION FORM !/ Information Worksheet �� j I.lt" (-�t-� JOB STREET ADDRESS: �7 ¥ 2 3 & Ca CITY/STATE/ZIP: 4,14- 91U6 PARCEL NUMBER: ' PHONE NUMBER: 9/022 — 63 7 MAILING ADDRESS: E--/ �f4FL3 a: �oe�pOZN+ce. /.t//1- 94 4 (Street) (ity/State) (Zip) ;,CONTRACTOR: i1OL&io1 .</c LICENSE•NUMBER: "4t �% T.!arf/CG ' PHONE NUMBER:.;'9z'g 6 5 S OWNER: She- 4�klJf MAILING ADDRESS:', e- 13 It •t - C/' ��pC✓17_ �1 ( (J . (Street).. . (City/State (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOVE/INSERT GAS WATER HEATER GAS EQUIPMENT <1 Q0,000 8tU (INCLUDES GAS EQUIPMENT+100,000 BTU DUCTWORK) GAS PIPING,(EA.OUTLET BOILER/REFRIG 1-100M BTU BOILERIREFRIG 101-5OOM BTU BOILER/REFRIG 501-1,000M BTU BOILER/REFRIVG 1,0001, 1,750M BTU.' BOILER/REFRIG +1,750M BTU ;HEAT PUMP & AIR CONDITIONER 0 3 TONS HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT PUMP & AIR CONDITIONER 15 30 TONS ,_ • HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMP & AIR GONOITIONER +50 TONS VENTILATING FANS `EVAPORATIVE COOLEI TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE H.O,O,D._..._._.. CLOTHES DRYER RANGE,_.;;. GAS LOG ,MISCELLANEOUS.(NOTCOVERED ELSEWHERI I UNLISTED GAS APPLIANCE <400:000 BTU;*:. : ULINSTED :GAS APPLIANC E >400,000 tTUr USED APPLIANCE <400,000 BTU ,USED APPL1ANCE_>400,000 BTU AIR HANDLER <10,000 CFM. _ 'AIR HANDLER >10 000 Cl NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x10.00 = x ,12.00 ... x15.00":= X 1.00 = x 12.00 = x 20.00 = x25.00 = x 35.00 = x60.00 = x 12.00 = x 20.00 = x25.00 = -x35.00 = x60.00 = x10.00 = x 10.00 = x 50.00 = x 10.00 = x 10.00'= x 10.00 = x10.00 = x.50.00 =' x100.00 = x 50.00 x100.00 = x 12.00 •x,15.00 t , . %Z. poi • .. °. ') / 1. 0 0 . . ' r"„ SUBTOTAL?;` ^4 PLUS: PROCESSINGFEE'- +$ 25:00 EQUALS::TOTAL PERMIT FEE DUE _$ .38.00 Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675