1992, 08-13 Permit App: 92006405 Wood StoveMECHANICAL PERMIT APPLICATION FORM
1 /Dln(ormation Worksheet
JOB STREET ADDRESS: E J L � 5 p(rf'QG P� C� ^� 1 / .
CITY/STATE/ZIP: J� IPar7 P -/ II/AT !'7=046 PARCEL NUMBER: yS� ! v[ , ,d-iL3 V3
OWNER: Kr 2r� Y Q,!^Ci li du �iJP/) PHONE NUMBER: 9,2 S - 6 �y7� 8ot-
Faal S
a
MAILING ADDRESS' E.�ll ,/Qf (1,t -r re? Ce- i
0 (Street) (City/State)
CONTRACTOR: u0 (I £K LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS' S4'V'2 e -
(Zip)
9c2 F -(08 yS
DESCRIPTION
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSEI T'' *• .''
GAS WATER HEATER
GAS EQUIPMENT;.c 00,00(1SW(INCLUDES`;::
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING..(EMDUTLE j
BOILER/REFRIG 1-100M BTU
11,01.a/1.3g0.014:914,0,0::. _
BOILER/EFRIG 501-1,000M BTU
BOILER/REFRIG 1 0001; 7 Z50M BTU;: `:.
BOILER/REFRIG +1,750M BTU
HEAT PUMP &.'Al14 CONDITIONER O -STNS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
H EAT PUMP$& AIR COND(TJONER j5SG 10NS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP:;'&<AIRCQND.LTION1'#.5..0;TONS
VENTILATING FANS
EVAPORATIVE;GQQLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
MISCELLANEOUS (NOT;. COVERED; ELSEWHEF
UNLISTED GAS APPLIANCE <400,000 BTU
ULI LASTED.G.ASAP.PLIANCE`>ti00;p00.aB
USED APPLIANCE <400,000 BTU
USED: APPLIANCE:4O'0r000?STU. ;:i .'I
AIR HANDLER <10,000 CFM
AIR HANDLER>:10 000'.:CFM :;:
NOTE: MINIMUM PERMIT FEE IS $35.00
- (Zip)
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 =
x20.00 =
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 =
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 =
x12.00 =
x 15.00 =
. /
0?, -5,
•
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ .JQ,k"
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675