1993, 03-18 Permit App: 93001583 Water Heater, PipingMECHANICAL PERMIT APPLICATION FORM
/
l (.o . t/4Int rmatio�pnWorksheet r ,
JOB STREET ADDR ESS: / 90 / -e <x-e/c c-C� W
q3-st3
CITY/STATE/ZIP.�%711J�G_ X2.1 LQ. %%ao%
OWNER: "l) a,, e
MAILING ADDRESS: 0
PARCEL NUMBER:
PHONE NUMBER: 967i 1- gas --(0
J
yy�� ^ (Street)
CONTRACTOR' // A . / 426-1-1,:i } 7
MAILING ADDRESS:TO' -8132(h JI C,(1- 49
(Street)
DESCRIPTION
(City/State) h (Zip)
LICENSE NUMBER: N 03 /' & RN, /C- /6 2 T Y
PHONE NUMBER: 9 `f kg 9
Ix.Ra-til teti W A. • 1913/5'
City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT :::':::::.::.
GAS WATER HEATER
'.GAS EQUIPMENT.000,000 BTU (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG .101 T500M. BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG?;1, 0:001-1 i750M,BTU..
BOILER/REFRIG +1,750M BTU
HEAT: PUMP,;8, AIR :CONDITIONER, 073: TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
:HEAT; PUMP &;.AIR:CONDITIONER`;15-30:TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP:&:AIR CONDITIONER TONS::
VENTILATING FANS
EVAPORATIV QOOLERS ; ::::::
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE.,;
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED!GAS:APPLIANCE>400,000:STU.:
USED APPLIANCE <400,000 BTU
,USED:AP:PI ,ANCE: '400,000;STU::::::::::::.::`
AIR HANDLER <10,000 CFM
AIRHANDLER>1.0;000:CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane. WA 99260 (5091456-3675
NUMBER
OF UNITS
X EACH
UNIT
= 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 a
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 -
x 60.00 =
x 10.00 =
x 10.00 a
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 =
/
/D 0-0
/
/• 0
SUBTOTAL
$ //6C
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ .36 it