1993, 01-29 Permit App: 93000473 Water Heater, PipingMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: E. 11004 Grace
CITY/STATE/ZIP:Spokane, WA 99206 PARCEL NUMBER:
OWNER: Mark Deboodt
PHONE NUMBER: (509) 927-7444
MAILING ADDRESS:
CONTRACTOR:
(Street)
Steinmetz Heating
MAILING ADDRESS: N 2114 Pines
(Street)
(City/State) (Zip)
& A/C LICENSE NUMBER: STEINHA147KF
PHONE NUMBER: (509) 922-2034
Rd. Suite 3
Spokane. WA 99206
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING -EQUIPMENT <100,000
HEATING EQUIPMENT +100,000
GAS PIPING , (EA .OUTLET)
REFRIG 1-100M BTU' (NOT A/C OR HEAT PUMP)
REFRIG 1O1-500M.BTU
BTU
BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP It
HEAT -PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
0-3 TONS _
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS _
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12'
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
PTN. OF HOOD)
MISCELLANEOUS (NOT COVERED
UNLISTED GAS APPLIANCE <400
UNLISTED GAS APPLIANCE >400
ELSEWHERE)_
,000 BTU_ _
,000 BTU_ _
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM
= AMOUNT
x$?0.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00
x 20.00 -=
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 =
x 12.00 =
x 15.00 =
IO.DO
l• 00
NOTE: MINIMUM PERMIT FEE IS $35.00
Spokane bounty Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675
SIGNATURE
SUBTOTAL
$ *00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 36. c•