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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