1992, 09-25 Permit App: 92008365 Mechanical Fixturesvb5
MECHANICAL PERMF( APPLICATION FORM pate: 74 s/' _
Informationrk
Wosheet
`1 -
JOB STREET ADDRESS: S a7 I ^ b i,4) IM.Qh - Nl i c RoJ
CITY/STATE/ZIP: 52 �
17'h.& (A, - PARCEL NUMBER:
Y�
OWNER: 2h (-taueh PHONE NUMBER: 9.24/ 6 F
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: Ripley's Plumbing, Inc. LICENSE NUMBER: RIPLEP1107B6
PHONE NUMBER: 509-535-1919
MAILING ADDRESS: 4104 E Pratt Spokane, WA 99202
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT - . -
GAS WATER HEATER
GAS EQUIPMENT<100,000 BTU (INCLUDES -' 5 -
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS.eipiNG (EA OUTLET)
BOILER/REFRIG 1-100M BTU
:BOILER/REMIGl0Ti-500M:BTU:
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG`1,00011-,750M BTUT.`
BOILER/REFRIG +1,750M BTU -
HEAT PUMP & AIR CONDITION ER03 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 CONDITIONER +50 TONS . - -
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12
TYPE IIHOOD
CLOTHES DRYER
RANGE
GAS LOG
MISCEiiAtJEOUs`(NOTCOVERED EtEWHEREs=
UNLISTED GAS APPLIANCE <400,000 BTU
VONSTED GAS APPW4, NCE400,000BT31:;..; _ =
USED APPLIANCE <400,000 BTU
IiSEO IPI:1341C '3 o 00b:nm
AIR HANDLER <10,000 CFM
AIR:HANDLER>.10000CFM_' .;
NOTE: MINIMUM PERMIT F IS $35.00
SIGNATURE Q
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= 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 =
x25.00 =,..
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 =
to. o0
0_00
2-.00
SUBTOTAL
$ -'-{oo
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS* TOTAL PERMIT
FEE DUE
q
= $ 700
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675