1992, 11-24 Permit App: 92010342 Gas Log, PipingJOB STREET ADDRESS:
CITY/STATE/ZIP: 4t • . I AjC(. ctap(» (r, PARCEL NUMBER: r y
OWNER: 4 PHONE NUMBER:5(3�') - Ic / 00/ 1
MECHANICAL PERMIT APP1ICATION FORM
Inform - tion W eet
MAILING ADDRESS:
(Street)
(City/State)
CONTRACTOR: Heat Transfer Inc. LICENSE NUMBER: H e a t t i -18 81 n
PHONE NUMBER: 3 2 8- 3 4 00
MAILING ADDRESS: N. 1008 Ruby Spokane, WA 99202
(zip)
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOOD.STOVE/INS1=HT_ < ::::........................... A..
GAS WATER HEATER
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET.::
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 501-1,000M BTU
»oIL1=i EFRi•G` '>FO Q1 ,750M T
...:..............................:......................................•......:
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIRCONDITIONER
HEAT PUMP & AIR CONDITIONER 30-50 TONS
.......................
HEAT PUMP 84 AIR CONDITIONER +50•TONS'<
VENTILATING FANS
EVAPORATIVE ,COO.LER
TYPE HOOD
(PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
RAN.:...;...
GAS••LOG:_:.�::.............................................................:.................................. ...
MI.S EU..ANEOUS'' .<.k:I.Ti OVERED E1:e�7..EWH E'•'•%Yr}�yk Y>.
UNLISTED GAS APPLIANCE <400,000 BTU
wrw:
.�:r»:x• :, �:rs, w-:•::::::s•:�::�:S:vc.:•..;:.v:::�.,�:>,.-::w::�; o�r:-i�::'::�:-:a:�=:i%;?.
USED APPLIANCE <400,000 BTU
t(S A I'f Alit N fix• - f ROP
vvh,•.,w sx:w,,,,•n6imn ••hi::v:.•:: hv:Fw�:iiiv. nAv..nx::vi: •Y.�nl•Sf ni};.iu+ix..w -
AIR HANDLER <10,000 CFM
.tin}:::vW t''";:x.}: w•f.:.v..}}•:.•: ,y-..vv�v}nkw.:yvn}} W
arl�::�I'alao>€�1=t�:��t
•
°i
NOTE MINIMUM PERMIT FEE IS $35.00
SIGNATURE cc.
(zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 2--
x 25.00
x25.00 =
x 10.00 =
-::
x 12.00 =
x 15.00 =
'k
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x60.00 =
x 12.00 =
x 20.00 =
x25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x10.00 =
x 10.00 =
j, 6
x10.00=
,on
x10.00 =
x50.00 =
x100.00=
x50.00 =
x100.00 =
x 12.00 =
x 15.00 =
SUBTOTAL
$ /45-e
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ j 4.0c)
Spokane Co Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675