1993, 02-08 Permit App: 9300675 Mechanical FxituresCA -2-3 �- • of fl -3 MECHANICAL PERMIT APPLICATION FORM 5. toi �-';
,0 ��'";, (.,1), SX:)03 L.► 3 , 6-J Information Worksheet
15QC 1
JOB STREET ADDRESS: 5 D// re)ifrg5 / /713Pir4lC1zCJS
CITY/STATE/ZIP: J/7O / / x ,6 , SGL WW, PARCEL NUMBER:
OWNER: \) --G' W.' ,5-,/�1-/e d- PHONE NUMBER: /� -6Q/7
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: Heat Transfer Inc. LICENSE NUMBER: H e a t t i -1881 n
PHONE NUMBER: 482-2000
MAILING ADDRESS: N. 3003 Crestline Spokane, WA 99207
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
OF UNITS
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GODS ...... INSER'1
GAS WATER HEATER
::.. QU 4 .... £A fOt#,t100 BTU
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG .501-1 .,000M BTU
BOILEI /REFRIG I,0001 1,750M BTU . f:.
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0 3.TC
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP B& AIR CONDITIONER:15:- 30 TONS :;
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR CONDITIONER;+50 TONS
VENTILATING FANS
TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD)
TYP ....I
CLOTHES DRYER
GAS LOG
CE•S•.€.ANEOUS ( OTCOVEREDELSEWHERE :
UNLISTED GAS APPLIANCE <400,000 BTU
X EACH
UNIT
= AMOUNT
USEDfAPPUANCE <400,000 BTU
AIR HANDLER <10,000 CFM
ahs;
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 =
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 =
/i9, aZ4•
/ b
,6b
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE 710411 u`ti -" �' t
pokane County Division of Buildings
West 1026 Broadway Avenue Spokane, WA 99260 (509) 456-3675
SUBTOTAL
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
FEE DUE
+ $ 25.00