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1989, 11-03 Permit App: 89004501 Water HeaterJOB STREET ADDRESS: CITY/STATE/ZIP: OWNER: MECHANICAL PERMIT APPLICATION FORM Information Worksheet 6 JuAt 74-44 MAILING ADDRESS: 46 (Street) PHONE NUMBER: CONTRACTOR: MAILING ADDRESS: q2q- 75S /� Q� (City/State) (Zip) j0 J" p}7l GC-( LICENSE NUMBER: PHONE NUMBER: 7 -/ / 7U_. 7` . 3 i &/ OeL-- q612.40 (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 PIVING (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 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' PTN._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 <400,000 BTU USED APPLIANCE >400,000 BTU AIR HANDLER <10,000 CFM AIR HANDLER >10,000 CFM x$10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x 4.00 = 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 = tocD NOTE: M IMUM PERM FEE I8 $ 5.00 SIGNATURE - /A.- Spokane County fepartment of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 SUBTOTAL PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE $ 356°