1992, 11-24 Permit App: 92010348 Water Heater, PipingMECHANICAL PERMIT APPLICATION FOR
Information Worksheet'
JOB STREET ADDRESS:--3�2.1 C� ita=d Zd •
CITY/STATE/ZIP: 2. PARCEL NUMBER: •5 /14 e/e 7
el.... • A
OWNER: L:
MAILING ADDRESS:
\r \-C"c
PHONE NUMBER: 012- /4--- l0 D S (7
CONTRACTOR: Gmf-A C\
(Street) (City/State) (Zip)
5-a rt 1 C'f1.06,-Ira (Arai, t�r1C • LICENSE NUMBER: G D k_ 1>S M ZG Q C4 -
PHONE NUMBER: SSS"SCI i14
MAILING ADDRESS: S Z. 4-
DESCRIPTION
.••I'
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
`y N1:4iF
GAS WATER HEATER
GAS EQUIPMENT +100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 501--1,000M BTU
BOILER/REFRIG +1,750M BTUErcr
.a:
E� A i :icy s +• vo:
HEAT PUMP & AIR CONDITIONER 3-15 TONS
ka
HEAT PUMP & AIR CONDITIONER 30-50 TONS
VENTILATING FANS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD
<">:•C"Zvi;
44,4.4
CLOTHES DRYER
ragiA
GAS LOG
v.o..re! :: . iuc::«i::i :Ya
<y<�l r y:..A:S'.<ry.�i 11. U �� . •Y!- K .3..:7.1 . Jk, �^! y Y' r
r.,t 4q-' :
UNLISTED GAS APPLIANCE'�S'<400,000 BTU
r "5^VW: Y Y "Sx52tii^ r9r
USED APPLIANCE <400,000 BTU
AIR HANDLER <10,000 CFM
It1S ` ANS? FINSOr
Wit
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
••
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x10.00 =
x 12.00 =
x 15.00
‘
I b -00
I
x1.00 -
1.00
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 mg
x60.00 =
x 12.00 =
x 20.00•
x25.00 an
x35.00 =
x60.00 -
X 10.00 le
10.00 =
x 50.00 =
x10.00
x 10.00 =
x10.00c
x10.00 =
x 10.00 -
x 50.00 =
x100.00 0
x 50.00 =
x100.00 =
x 12.00 =
X15.00 =
t
‘.x
SUBTOTAL
$ 1 1 .00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_• $ 3ln' Ob
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 4563675