1993, 03-22 Permit App: 93001669 Water Heater, PipingJOB STREET ADDRESS'
CITY/STATE/ZIP:
rattalANILALrth7H1 RrruuAIIUN FUHM (Nic-
Irformat-ion Worksheet __iv.
?3Co;' , ,22,= 4?t2L /eof
PARCEL NUMBER:
OWNER: addin a/,;A PHONE
MAILING ADDRESS: 33062 -Y. QZf J- 12ct
(Street)
CONTRACTOR -V/ /Qg///-414CIV
MAILING ADDRESS: "OJT 3"70"7
(Street)
`8\
NUMBER: /.2 g.' 30 r
LICENSE
PHONE
tca�l-.v, Gr.) .4 g9.3/a
( ity/State) (Zip)
NUMBER: 6.g- -5/2- 3702/x7"
NUMBER: ' L/4'a- 'Slob's
( ity/State) (Zip)
namlanzszlzvasmomemzismar
MECHANICAL WORKSHEET/FEE
DESCRIPTION
SCHEDULE
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
DUCTWORK SYSTEM_ _ _ _ _
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 ETU
HEATING EQUIPMENT +100,000 ETU
GAS PIPING (1 --4 OUTLETS)
GAS PIING (5 OR MORE. EACH:)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
VENTILATING 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 <10,040 CFM
AIR HANDLER >10,000 CFM
(
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 19.
x
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 30.00 =
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 =
/0 • 00
/- 00
NOTE:
SIGNATURE
N
T FEE
ezto
S $35.00
Spol�ane'f'rdunty Department. of Building and Safe
West 1303.Broadway Avenue, -Spokane; WA :99260(5
s'
SUBTOTAL
$ //.00
PLUS: PROCESSING FEE!+ $ 25.00
EQUALS: TOTAL PERMIT
. FEE DUE
C.1
9).,456-3675 -