1990, 06-06 Permit App: 90002532 Water Heater, PipingMECHANICAL PERMIT APPLICATION FORM
Informattion Worke-beet
JOB STREET ADDRESS: 5, a 8080 rex a33a
CITY/STATE/ZIP: SFJOKLI ra tki• PARCEL NUMBER:
OWNER: Dor'O+haj i-hcnm&S
MAILING ADDRESS: <:).28.4,720 Fox 3finkan. tIJ4 .
(Street)'(City/State) (Zip)
CONTRACTOR: A R4 lJcJiaf l ill Er [.'tn/ oll /we.
PHONE NUMBER: %a& (073 7
MAILING ADDRESS:
Near L lla_ ed •
LICENSE NUMBER:
R1,ez vNiJtl/OH
PHONE NUMBER: gat 00/
(Street)
SOokeuu cva
(City/State)
49a ,3_-•
(Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000
HEATING EQUIPMENT +100,000
GAS PIPING (EA OUTLET)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
BTU
BTU
REFRIG 1,00
REFRIG +1,7
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
EVAPORATIVE
TYPE I HOOD
TYPE II HOOD
CLOTHES DRYER
RANGE
1-1,750M BTU
50M BTU
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
COOLERS
(PER 12' OR 12'
PTN. OF HOOD)
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE)
UNLISTED GAS APPLIANCE <400,000 BTU
UNLISTED 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
l
= 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 =
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 =
AO.00
/,00
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
$ /1. 00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= s 3Aoa
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (5 9) 456-3675