1992, 03-27 Permit App: 92001922 Gas Log, Piping= s3;
ECHANICAL'PERMILAF OffoM1Oa FORM
Information Worksheet
JOB STREET ADDRESS: F
CITY/STATE/ZIP: S p +c a _t PARCEL NUMBER:
OWNER: G'F'or” j< rrc.J 47—e r PHONE NUMBER: 9G L d ry A 9
MAILING ADDRESS: 5-4 Pa C.__
(Street) (City/State) (Zip)
CONTRACTOR: MSM INC (MARTIN SHEET METAL INCLICENSE NUMBER:MA RT IS M170KW /C600 470 101
PHONE NUMBER: 924-8088
MAILING ADDRESSBLDG 103 SPOKANE INDUSTRIAL PARK SPOKANE, WA 99216-1609
Pp)
DESCRIPTION
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
OF UNITS
XEACH
UNIT
= AMOUNT
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
W,O_ODSTOVE/INSERT
GAS WATER HEATER
GAS EQUIPMENT<100 000 $TU INCLUDES ;
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPI.NG'(EA OUTLE I)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 701 500M BTU
BOILER/REFPIG 501-1,000!.I P-
BOILER/REFRIG +1,750M BTU
HEAT'PUMP & AIR COND1TfON_o
HEAT PUMP & AIR CONDITIONER IONER 3-i5 TONS
H.EAT7 `? „'? _
HEAT PUMP & AIF-; CONDITIONER 30-50 TONS
HEAT PUMP 8 AIR -CONDITIONER +50 TONS
VENTILATING FANS
:EVAPORATIVE COOLERS
TYPE! HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE 1I HOOD
CLOTHES DRYER
RANGE,.
GAS
ANGE -
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANCE >400,000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE> 400,,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10;000 CFM
x 10.00 =
x25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00 =-
X
x 20.00 =
5 ^C
X 60.00 =
x:?.C"
x20.00 =
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 =
x50.00 =
x100.00 =-
x 12.00
x12.00 =
x 15.00 =
1
/0
NOTE: MINIMUM PERMIT FEE IS $35.00
SUBTOTAL
1S
+S
PLUS: PROCESSING FEE
25.00
EQUALS: TOTAL PERMIT
FEE DUE
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675