HomeMy WebLinkAbout1992, 10-06 Permit App: 92008478 Water HeaterMECHANICAL PERMIT,APPLICATION FORM
Informati %i Worksheet
IIMLES
JOB STREET ADDRESS:
C/E��Y/yyS��T�ATE/ZIP: _S/�o,�fii..G w✓) . PARCEL NUMBER: / /
OVI�JER:'7 �,fl%r/d n�zr PHONE NUMBER: `/ I T
MAILING ADDRESS:
CONTRACTOR:
(Street)
MAILING ADDRESS:
DESCRIPTION
(City/State) (Tp)
LICENSE NUMBER: -CD4-/rSrN ?i 1p tM (,t
9?Y-3'/ 38
A/co NU BER:-Jai
(Street)
A/cod
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
SAS'EQUIPJSff 1:0&bboBTU:QINCTt1 S
GAS EQUIPMENT+100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
pILRhi1G>1ati1517tiK4w>8'11
BOILER/REFRIG 501-1,000M BTU
10.1,:gTjegfr1(Gm11 ktV54N
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER2-15 TONS
P Mp, B?A-IKON4iT C NEF O is
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEA. <. ` Fq :.:<' Fr•..::.,w::<:.::.:::.:...:..:.:..: ,. y ..:::
,:...,..:.,.: PU,..,p:>&;AIR>COhiD1T�:ON_F�F3„�StlTOt�S
VENTILATING FANS
TYPE I HOOD (PER 12' OR 12' PTN. OF -HOOD)
.E'f`lHt7.....,.
CLOTHES DRYER
GAS LOG
QIP0EL4NEO.U.S:':(NOT:;C01/E11i 17 41
UNLISTED GAS APPLIANCE <400,000 BTU
U41.NSTE14:GA:$ APP .14NCE; 49.0,0 H
USED APPLIANCE <400,000 BTU
;USED _APPLANG0,z400;i)40`0'TU
AIR HANDLER <10,000 CFM
AIR HANDLEI1>>'101QAO CEM
s,
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
- (MP)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x25.00 =
x 10.00 =
x12.00 =
x15.00 =
x 1.00 =
x12.00,=
x 20.00 =
x25.00 =
x 35.00 =
x60.00 =
x 12.00 _
x20.00 =
x 25.00 =
x 35.00 =
x60.00 =
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 =
s
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675