1991, 08-20 Permit App: 91005152 HeaterMECHANICAL PERMIT APPLICATION FORM
information Worksheet
JOB STREET ADDRESS: fl %Z .7 PWR_
CITY/STAT
OWNER: , d,
MAILING ADD - SS:
PARCEL NUMBER:
PHONE NUMB R:
(Street) (City/State)
CONTRACTOR: LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(Zip)
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
...................................................
GAS WATER HEATER
................................................
GAS EQUIPMENT <100,000 RTU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
.....................................................
GAS. PIPING (EAw OUTLET
BOILER/REFRIG 1-100M BTU
>,
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG +1,750M BTU
HEAT PUMP $AIR CONDITIONER 0 0 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
....................... .
HEAT PUMP & AIR CONDITIONER 15 30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
AIR HES DRYER
G•
+50 TONS
VENTILATING FANS
EVAPORATIVE COOLERS.><:>`:.:::<::
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
RANG E
GAS LOG
MISCELLANEOUS;(NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
.. ..........................
ULINSTED GAS APPLIANCE >400,000 BTU
USED APPLIANCE <400,000 BTU
....SE..........D......................
UAPPLIANCE>400,000 BTU
AIR HANDLER <10,000 CFM
........................
AIR HANDLER >10.000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(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 =
x 25.00 = . .
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x25.00 =
x 35.00 =
x60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675