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1992, 04-15 Permit App: 92002505 Wood Stove
r 33;64 ±.,4tV 440. • r.•. • MtD iwMe YG' MECHANICAL PERMIT APPLICATION FORM 6i9 Information Worksheet t ' 's •,:,: , Is9"' JOB STREET ADDRESS: 5&5 �[)CI CITY/SSTAT IP:.j%k-,•-Q, )- .,'9 262-8/c; � A' PARCEL NUMBER: ; :.> .c-.:.,....,•.w:...a: ` .- ; i<a; .,, , OWNER: 11R4FL' �j' 840181No PHONE NUMBER:• .. 7:*•;''j}''' MAILING ADDRESS: 'i,,._, ,,':4;� -5:i1 (J 1aa (Street) = (City/State).' :,. (:;,.::.i:<• ' ;,:; ^,(4113) ...CONTRACTOR: /t qi, d..4 (2Cr,..L LICENSE NUMBER: '44 i LS 17o k 9 • '` I I' i /� � � PHONE NUMBER:'"' ,322$7..—Jat MAILING ADDRESS. 7 '6-o-LN—L /20-- 20'4".4;k:iti; 5'9Jo» (Street) a MECHANICAL WORK I 'W,. DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOVE/INSERTz`::: y': '',..:: €:.':.: GAS WATER HEATER%. :PAS EQUIPMENT <100,000.BTU,.(INC�UD GAS EQUIPMENT+100,000 BTU DUCTWORK) GA$ PIPING,(EA:OUTLET)::'.:::..:A, 'w •' BOILER/REFRIG 1-100M BTU BOILER/REFFIIG; lD1-500M::$1 BOILER/REFRIG 501-1,000M BTU OOILER/R........................................... BOILER/RFRIG +1,75M BTU .:... .. .:.. . • HEATPUMP &:AIRCQN9I,TIONER0TONS :. • HEAT PUMP & AIR CONDITIONER 3-15 TONS . HEAT.PUMP & AIR.CQNDIT.IONER HEAT PUMP & AIR CONDITIONER 30-50 TONS :HEAT PUMP;&;AIR1CONPITIONEA;.+50 SONS;..;;. VENTILATING FANS 'EVAPORATIVE COOLERS ; TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) 'TYPE II;HOOD?::'i?>: CLOTHES DRYER GAS LOG -MISCELLANEOUS;(NOT.COVPREO _ELSEWHERE: ,`: UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED GAS; APPLIANCE>400,000 BTU:.:. • USED APPLIANCE <400,000 BTU • USED !'PLIANCE >400,000 AIR HANDLER <10,000, CFM AIR;HA001ER>.1,0;000.C90':::,. r NOTE: 1•dINIMUM SIGNATURE PERMIT FEE IS $35.00, NUMBER OF UNITS •' :: X EACH -: UNIT'' `.. `: . '. = AMOUNT • x 10.00 = x25.00•=: _x 10.00 =t;.,:: :x12.00'=k.7."' x.15.00=•. . X:12.00=.=•°„ ,:x20.00= ` x 25.00.=7.",� x35.00,=;..,.,,. Vx60.00.0: x12.00 _="ih.Sa x 20.00 =:.- : x25.00._"? x35.00:=• .:: ,,.. . . I •. :, . P-5-. es- . .r_,,:r .1 :'"• :,1 , ', .. i, `K<' .t,. '.,t..,,.,„;id• .. .. iigrt _ r.'" .. .. :_. 'x60.00`._ x 10.00 = . x 10.00 '_ x 50.00';= ' x .10.00 = '. x10.00,_'.`' .x10.00 = • x 10.007=;,..;, . x 10.00 =;,::, x 50.00 _:,3.( x100.00.=•R'; •x 50.00 =„; T x100.00=:' .:.x12.00._.., x15.00'= :.s- V4 ::-.. ' ,,, , • . .. ;. ' • • • T. _ - • . ' • .,, ,:.::••• .. _ ,.� :.:.' "r-..': ... .. . _. ,., . ._.,.,., SUBTOTAL , r,. , :, . $ 5 ‘2,'° PLUS: PROCESSING FEE",`4%dE'' + $ ,:'•, 25.00 •. EQUALS: TOTAL PERMIT.;,"-$ .. FEE DUEh, ?1 ., $:' ,n;'.;. Spokane County Division of Buildings:t,: ,..„ii .; y. Westt1303 Broadway Avenue Spokane: WA 99280 ('0Q1`45R-qR7�„ ., ;.. I P 14.