1991, 08-15 Permit App: 91004757 Gas LogJOB STREET ADDRESS:
CITY/STATE/ZIP:
OWNER: -771A-kt
MAILING ADDRESS:
CONTRACTOR:
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
E. Igor FAthek 04757
(44 91g44SRCEL NUMBER: eV57141-02g,/
AA.Aile444, PHONE NUMBER: 97Y - t37
(Street)
A 2. M e!.11.71!!!"1"::::,
E. 12710 Indiana
Spokane, Washington 99216
MAILING ADDRESS:
(City/State)
LICENSE NUMBER:
PHONE NUMBER:
(Street) '• _
AMQUAHE 193N1
(Zip)
928'7106
( City/State )i?„--; ( Zip)
• MECHANICAL WORKSHEET/FEE SCHEDULE.
DESCRIPTION JI:.• ; OF UNITS. -=';AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT,1 j.L.I.L7,i'f:S.:
GAS WATER HEATER .i.
HEATING EQUIPMENT-abUiUckETU::
HEATING EQUIPMENT +100,000 -BTU .-*W
1
4(7vpif
GAS PIpING (EA OUTLET) :e02:
REFRIG':1-100M.BTU.(NOT;A/C0 HEA PUMP)'
REFRIGJ.617500M:BTU
REFRIG 501-1,000M BTU-'..?' .,..‘..:V.,T,
REFRIe1,001-1;750W:BTU7
REFRIG +1,750M BTU,-:• -.0. cc...,:,;_-5.,:z,r%,,,.
HEAT PUMP & AIR CONDITIONER 0.3 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.+50TONS:''
VENTILATING FANS . ., .
EVAPORATIVE COOLERS ‘ - - -, ' -.:';';'•
TYPE I HOOD (PER 12' OR 12! PTN:'OF'HOOD)
TYPE II HOOD .
CLOTHES DRYER .--
RANGE L.
GAS LOG
MISCELLANE S (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
MIbejnT E ITSIS $35.00
1
SUBTOTAL
x$1o:06,;T:
*45:00q
x41200
pe1;A:700
x:25:00,-!=
X,3500„!,-7.
x 20.00 =
x 25.00 =
x 60:00':=
x
x 10.00 =
x50.00,=
x10.00 -+-
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 =
ID • O'R
$ /c9 Ca
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
$ 3C.bb
Spokane County Department of Building_ and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675