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1993, 04-09 Permit App: 93002318 Water Heater, Piping (: t)eD dNs -9- ECHANlCAL PERMIT APPLICATION FORM a N�� a `NS ,AO c� Information Worksheet. k. 70B STREET ADDRESS: .,k4 Ttt U ' - DicA.__ R.O V `T CITY/STATE/ZIP: !? 4,0-- °; 00,k, PARCEL NUMBER: _ .� OWNER:, ) dA___ _C. it . P, _ PHONE NUMBER: (V1-t-71-19C,. . MAILING ADDRESS: ..n1afi..__ _ .___ - (t.treet.) (City/State) (Zip) ' CONTRACTOR: DAQ() 1 ‘., E3iiUC _iL• Cock, LICENSE NUMBER: 'S'iN?OPti it-14A _. _ PHONE NUMBER:__ Ci�'�-1-) `� ` MAILING ADDRESS: 14Qt-11 Efl'6�._... .T'_.1U1______._--- 5S )r<A , k..'vfl9c-, -30-(,;._ ('Street) (City/State) (Zip) _, ummonw :� MECHANICAL WORK-`.SHEE'P/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT s AMOUNT DUCTWORK SYSTEM _ _ _ x$10. 00 - - WOODSTOVE/INSERT _ _ _ _ X 25. 00 - GAS WATER HEATER T - _ r _ X 10.00 = 4O,0c, _ ' HEATING EQUIPMENT <100,_000 ETl" _ _ ', , ' x` 12.00 = _ HEATING EQUIPMENT +100, 000' BTU _ i , s' x15.00 GAS PIPING (EA OUTLET) . d x 1. 00 ,'a i , cc,, - REFRIG 1-100M BTU (NOT:A/C OR HEAT PUMP), a• ,t,..;, x 12.00 REFRIG 101-500M BTU v ,r.,.:,•+�;•�,. t:••; X -20,00•':= REFRIG 501-1, 000M BTU_ _ w_ _0, ' t`, , ,,1 , x25:00 REFRIG 1, 001-1,750M ':BTU , ,', x` 35.,00 REFRIG +1,750M BTU i s ,s,;;, , x, 60. 00 HEAT PUMP & AIR CONDITIONER 0-3 TONS ', 6' ',',''44k x' 12:00 - HEAT PUMP & AIR CONDITIONERL'3-15TONS , 1'•S,'r 1,1,11- , 3620. 00 L HEAT PUMP & AIR CONDITIONER,;15 3O TQNS ' r X 25 `00 7 HEAT PUMP & AIR CONDITIONER; 30- 50%'TON< sr,• ` ,.,- - x;' 35:00 --- HEAT PUMP & AIR CONDITIONER +50 TONS .;; X 60.00 _ VENTILATING FANS x 10.00 EVAPORATIVE ' COOLERS _ x 10. 00 TYPE 'I HOOD (PER 12T OR :12 ' P'I'N.. OF HOOD) x 50. 00. - _ TYPE II HOOD x 10. 00 = CLOTHES DRYER _ RANGE _ x 10. 00 = GAS LOG - - x 10. 00 _ MISCELLANEOUS (NOT COVERED ELSEWHERE) x 10. 00 UNLISTED GAS APPLIANCE <400, 000 BTU _ x 50 . 00 = UNLISTED GAS APPLIANCE >400, 000 BTU- -- __ _ USED APPLIANCE <4001000 BTU_ _ _ _�' W x 50. 00 - USED APPLIANCE >400000 BTU_ - _� _ _ _ M^ X100. 00 = AIR HANDLER <10,000 CFM - x 12 . 00 = AIR HANDLER >10, 000 CFM _ x 15. 00 - 1 SUBTOTAL $ iI PLUS: PROCESSING FEE +' $ 25 . ( EQUALS : TOTAL PERMIT NOTE: MINIMUM )ERMIT FEF 7s $35 . 00 FEE DUE = $ 5(p,OO 1 SIGNATURE . - "" -1 -------- Spokane County Department of Building and Safety Wost 13u3 Broadway Avenue Spokane, WA 99260 (509) 456-3675