1990, 10-18 Permit App: 90005499 Heater, PipingMECHANICAL PERMIT APPLICATION FORM
Irfo�ni'tion/ Worksheet
JOB STREET ADDRESS: / / Cr
CITY/STATE/ZIP:#, .0 /((77q
OWNER: gt--'Z / L 4 k -
PARCEL NUMBER: /WL"� -- Ae • pN�
-
PHONE NUMBER: 9,Q;17- a •9 n y/e/ C,/
MAILING ADDRESS: /3/:;0
/341.6A-LI� L)'�I /
(City/State) (Zip)
(Street)
CONTRACTOR: °AAA
MAILING ADDRESS:
Ob.
4 3 7C-7
LICENSE NUMBER: 0E - /19 -��
PHONE NUMBER: /?-//27 t'34/4
4-46,22e7, (L)/ �c�an
(City/State) (Zip)
(Street)
MECHANICAL WORKSHEET/FEE•SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
= AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIING (5 OR MORE. EACH:)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER 0-3 TONS _
AIR CONDITIONER 3-15 TONS
AIR CONDITIONER.l5-30 TONS
AIR CONDITIONER -3'0-50 TONS
AIR CONDITIONER +50 TONS
FANS
EVAPORATIVE COOLERS
TYPE 1 HOOD (PER i2° OR 12' PIN. OF HOOD.)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE)
UNLISTED GAS APPLIANCE <400,000 BTU_
UNLISTED GAS APPLIANCE >400,000 BTU_
USED APPLIANCE <400,0001BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM
f
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 1).9.21 _
x6-=
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 =
x10.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
l C(
SCC'
NOTE:
SIGNATURE
T FEE IS _n$35.00
1
SUBTOTAL
$ /3
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 3g
Spokan CouDepartment of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675