1994, 04-06 Permit App: 94002838 FurnaceJOB STREET ADDRESS:
CITY/STATE/ZIP: S ate. o. IA) 7 o t' PARCEL NUMBER:
OWNER: JI nKIo t' i.Cel PHONE NUMBER: 7 L - -3O
rf 4.
MECHANICAL PERMIT APPLICATION FORM'
p Information Worksheet
3057
MAILING ADDRESS:
(Street) (City/State) n i7 / (Zip)
J\) n -
CONTRACTOR: w /4 -yip Z &t7 LICENSE NUMBER: ND /Q Co A 0 7 6, 4.1
1 / PHONE NUMBER: S'/{ -41q1,5
'T--
MAILING ADDRESS: E C l o -„o,., I 5 p.,,.Gef.mt- LI% q .,, / ./
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOOD$TOVE/tN$ERT`;
GAS WATER HEATER
GAS EQUIPMENT <100,000 BTU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA .OUTL .: s..:_•
BOILER/REFRIG 1-100M BTU
:BOILER/REFRIG 101-500M STU
BOILER/REFRIG 501-1,000M BTU
.BOILERlREFRIG 1,0001-1,750M BTU
"BOILER/REFRIG +1,750M BTU
:HEAT PUMP & AIR CONDITIONER- 0.S TONS
HEATPUMP & 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
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
ULINSTED 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
NOTES MINIMUM PERMIT FEE IS $35.00
SIGNATURE
West 130r
NUMBER
OF:UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x25.00 =
x10.00=
x 12.00 =
x15.00 =
x1.00 =
x12.00=
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
/ og, 00
x 12.00 =
X20.00=
.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 =
x12.00 =
x 15.00 =
SUBTOTAL •
$ LI o 0
PLUS:' PROCESSING FEE
+ $ 25.00
E QUALS:TOTALPERMIT
FEE DUE.
=$-5'700
Spokane County Division of Buildings
'adway Avenue Spokane, WA 99260 (509) 456-3675