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1993, 04-08 Permit App: 93002327 Water Heater, PipingJOB STREET ADDRES CITY/STATE/ZIP: MECHANICAL PE3 MIDAPPLICATION FORM Information Worksheet 0A 5w/6 OWNER: Lon' G-/0 _Se r MAILING ADDRESS: , SG 0-1.1) (Street) _ CONTRACTOR: pc. T ('ont71015 itr MAILING ADDRESS: PO A!y ,/c/ 7V (Street) DESCRIPTION PARCEL NUMBER: PHONE NUMBER: (City/State) LICENSE NUMBER PHONE NUMBER: 10 o 6 4-- (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOVE/INSERT • '.'';' ` '. ' .c, GAS WATER HEATER GAS EQUIPMENT. <100,000 BTU (INCLUDES GAS EQUIPMENT +100,000 BTU DUCTWORK) GAS PIPING (EA OUTLET) BOILER/REFRIG 1-100M BTU BOILER/REFRIG 101-500M BTU BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG ;1;0001 1,750M. BTU BOILER/REFRIG +1,750M BTU HEAT. PUMP &"AIR'CONDITIONER0-3.TONS : HEAT PUMP '& AIR CONDITIONER 3-15 TONS ._ HEAT PUMP &=AIF CONDITIONER 15E3p'TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS :HEAT PUMP{8"AIR. CONDITIONER+5.0 TONS_ VENTILATING FANS - EVAPORATIVE COOLERS ;y TYPE I HOOD (PER 12' OR 12' PTNOF HOOD) TYPE ll HOOD 'S";i;r- ti>.: ; ...' .: :, <:tom . ... ... .: . CLOTHES DRYER RANGE GAS LOG MISCELLANEOUS (NOT COVERED ELSEWHERE umusTED GAS APPLIANCE <400,000 BTU uumSTED GAS APPUANCE >400,000 BTU USED APPLIANCE <400.000 BTU USED APPLIANCE >400,000 BTU uW.n4NDLER <10.000 CFM AIR HANDLER >10,000 CFM .. .. NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE ,e1/ .1ja 'a57 -s6 /7 g12/S- - x/751 (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x25.00= x 10.00 = x12.00 = x 15.03 = x 1.00 = x 12.00 = x 20.00 = x25.00= x 35.00 = x 60.00 = x 12.00 = x 20.00 = x 25.00 = x35.00= x 60.00 = x 10.00 = x10.00 = x50.00= x 10.00 = x 10.00 - x 10.00 - x 10.00 - .,; x 10.00 - /0 . / • - x 50.00 - - x100.00 - - x 50.00 - x100.00 - x12.00 = x 15.00 = SUBTOTAL $ /1 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ Spokane County Division of Buildings West 12,n'3 Proadwayy Avenue Snokane, WA 99260 (509) 45R_2675 7 z3