1993, 04-08 Permit App: 93002290 Water Heater, PipingMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: s•,9S0K-lac,Amaa, -"Mite c\.
CITY/STATE/ZIP: Sot, Kc h Q Cal . 752nL,PARCEL NUMBER:
9- - z - nu
gowo
OWNER: Po, f'ic k c h.Ly nri t/ PHONE NUMBER: C/) I - 4-/ i3S
MAILING ADDRESS.
CONTRACTOR: /7 w. Pro
(Street)
(City/State) n (Zip)
LICENSE NUMBER: A ; ✓ Pr', /4i/.J P
PHONE NUMBER* yr. ) 22?
MAILING ADDRESS:
(Street) (City/State) (Zip)
ck y�kCt-
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
VJOOpSYOVEI(NSItT
GAS WATER HEATER
GASrE(2UI,PM NT foottOt)STC? G 00_
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS< iltiii (LAtiti
BOILER/REFRIG 1-100M BTU
€SOILERMEFRIG t01
BOILER/REFRIG 501-1,000M BTU
[OPIAMON:d.r.466WIT -M
BOILER/REFRIG +1,750M BTU
[int OMOWS:01:01Yagt
HEAT PUMP & AIR CONDITIONER 3-15 TONS
At?;1laitre TRal Ta3NrI 'imS4(?:A
HEAT PUMP & AIR CONDITIONER 30-50 TONS
NSA'I f'llN(P WR'CQ ITi"Nff3l Tp tSw
VENTILATING FANS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
MIA µ:
CLOTHES -DRYER
fNl'�'f• c. Y.....:,., •pz':tiso;.d..£3s<...fiiM'•''"'H..::C:".'.ti^i3:'�•4„ii
GAS LOG
�:/n .wv:::u. ry:':p. { ... .::..•.A.i.. n v .rc vnw w:ne.:uv.
LMISG LI VAt EQGS (Vf t10:( ciji ,E1N. t
UNLISTED GAS APPLIANCE <400,000 BTU
�j:'.wq Mvb:.:M.w^Y.x w:.n,.u..`x....:.::.
U L INSYEW;'04WOGIAtVCE?4a00 00U. _»T11.µ'
USED APPLIANCE <400,000 BTU
US.ED'APF!1 ANGtWik$Ob` Uf.
AIR HANDLER <10,000 CFM
:.:............:M....,.,..�....r.,..y,.ann.»�n....w»n:.: �n....a%M ):'�°.:'c,. a.•y w.F..'i
A R HANb.I; l 10;0 `C
Yv'•
NOTE:. MINIMUM PERMIT FEE IS $35.00
SIGNATURE
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x20.00 =
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 =
x50.00 =
x10.00 =
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 =
- -
lO 00
i t
SUBTOTAL
$ 11
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 3�
Spokane County Division of Buildings