1993, 01-08 Permit App: 93000087 Water Heater, Pipingq701 6- /87
MECHANICAL PERMIT APPLICATION FORM
JOB STREET ADDRESS.
CITY/STATE/ZIP: 2() c»4qq,>?e)
OWNER: V22Out 7 -
MAILING ADDRESS' V
Information Worksheet Cj
2.c1 SO
PARCEL NUMBER:
PHONE NUMBER: S)9 c/7)
(Street)
CONTRACTOR4)Ct1 0, Aitat
MAILING ADDRESS i. ,573
DESCRIPTION
(City/State) (Zip)
LICENSE NUMBER: t ---)C4 e)/16•00 /2 Z.
PHONE NUMBER:
. iA)/9 /92) 7
(City/State)
(Street)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVFJINSERT
GAS WATER HEATER.... .......... , •
GAS EQUIPMENT d00,000 BTU (INLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK).
GAS PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU....
BOILER/REFRIG101500M
BOILER/REFRIG 501-1,000M BTU
p0lLaN.Fiaf91q100971..:4;750Kg3Tq
BOILER/REFRIG ...
HEAT PUMP & AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEArpomp....„.8,:m9...QpNpyrIpKR 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
AIfl HANDLER >10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
t SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
x 1 6.156 =
x25.00 =
x10.00 =
x 12.00 =
x 15.00 =
x 1.00 a
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 =
x10.00 =
x10.00 =
x 50.00 =
x10.00 =
x10.00 =
x10.00 =
x10.00 =
x 1,0.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
= AMOUNT
k) ez
SUBTOTAL
... I.
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ 37 d)
Spokane County Division of Buildings