1991, 10-23 Permit App: 91007425 FurnaceMECHANICAL PERMIT APPLKATTION FORM',
-7 Information Worksheet �/
JOB STREET ADDRESS' /a<2 UT. i• "1 t �0,e�
CITY/STATE/ZIP:•l
OWNER: sl - )X71491)
MAILING ADDRESS:
CONTRACTOR:
ki f � : PARCEL NUMBER: ' �2_eO/ 222-
%c] c F?Onod. • PHONE NUMBER: (7-2!S /_74;
(Street) ?Y,•
Heat Transfer Inc:.'
MAILING ADDRESS:
N. 1008 Ruby
(Street)
(City/State) (Zip)
LICENSE NUMBER: Heatti-1881n
PHONE NUMBER: 328-3400
MECHANICAL WORK
DESCRIPTION ••
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT: rr, •
GAS WATER HEATER
GAS EQUIPMENT. CI 00,000;BTU'(04CLUDES5;
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET) • .,
BOILER/REF:RIG 1-100M BTU
.BOILER/REFRIG 101L500M
BOILER/REFRIG 501-1,000M BTU
•BOILER/REFRIG 1,00014,750M BTU :.:.:.'.;;'';',
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0-3 TONS:
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER.15-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR CONDITIONER;+50:TONS,:':
VENTILATING FANS
EVAPORATIVE COOLERS 7,j
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
:RANGE
GAS LOG
MISCELLANEOUS° OTAbOVEREDi£LSEWHERE:
UNLISTED GAS APPLIANCE <400,000 BTU •
ULINSTED GAS APPLIANCE>400,000.BTU.
USED APPLIANCE <400,000 BTU
USED_ AppLlANCE,00i0Q06TU:"z,
AIR HANDLER <10,000 CFM
_AIR HANDLER° it7AQ0.CFM::' `,:,..:,:;..:
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
Spokane, WA
(City/State)
99202
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
__________
x 10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
/,2C--
x 15.00 =
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 =
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 =
SUBTOTAL
$ /.V
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
(J�
= $ t37/
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
OCT 2 3 1991