1992, 12-23 Permit App: 92011132 Mechanical FixturesJOB STREET ADDRESS:
Ny �v
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
1 -Rt
5
CITY/STATE/ZIP: Hprp )n`� -
)v
PARCEL NUMBER:
OWNER:
MAILING ADDRESS: �ZG
PHONE NUMBER: 9.;
(Street)
CONTRACTOR : PECK PLUMBING & HEAT ING
MAILING ADDRESS: 2708 NORTH RUBY
(Street)
(City/State) (Zip)
LICENSE NUMBER: PeckPH122DC
PHONE NUMBER: 328_ 4325
SPOKANE, WA. 99207
(City/State)
(Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS tUNIT
DESCRIPTION
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (EA OUTLET)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
0-3 TONS
3-15 TONS _
15-30 TONS _
30-50 TONS _
+50 TONS
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12'
TYPE II HOOD
CLOTHES DRYER
RANGE
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
PTN. OF HOOD)
1
1
= 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 =
x35.00 =
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 =
)5-,v
/ p
/D.00
NOTE: r, PERM SA 9 $35•00
SIGNATURE / ice/ mort-
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE - $
Spokane County Department of Building_ and Safe
West 13013 Broadway Avenue Spokane, WA 9260 (5 9) 456-3675