1992, 11-04 Permit App: 92009731 Water Heater, Piping1� \m t) -c)
.;
, JOB STREET ADDRESS: 72/7 2-
'''.:''.'iblidf'D' A1F'Pp..UC;h,'U'U'IM ninon!
.Cu 'uxmaL•ion Worksheet:
(9% 75
CITY/STATE/ZIP: J 00,hane 1-099,92/02 PARCEL NUMBER:
OWNER: ze r? ei d (-6/ i //
MAILING" ADDRESS:. ca in -C.,
(Street)
PHONE
NUMBER: 9:A/ -/7,Q6
CONTRACTOR: ANDERSON'S SHEET METAL
LICENSE
PHONE
(City/State) (Zip)
NUMBER: ANDERSM15RN?
NUMBER: 928-0960
MAILING .ADDRESS: E. 13903 TRENT AVE. SPOKANE, WA 99211
(Zip)
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT
:• DUCTWORK SYSTEM -
WOODSTOVE/INSERT
,GAS WATER HEATER
HEATING EQUIPMENT <100,000
',HEATINGEQUIPMENT +100,000
OAS. PIPING (EA OUTLET) _
'REFRIG:1-100M BTU (NOT A/C
101-500M BTU
'501-1,000M BTU
1,001-1,750M BTU
+1,750M BTU
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
REFRIG
' REFRIG
REFRIG
REFRIG
'HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT, PUMP &
VENTILATING
EVAPORATIVE
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
BTU
BTU
OR -HEAT PUMP)
0-3 TONS _
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
COOLERS
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 <10,0.00 CFM
AIR HANDLER'>10,000 CFM
NOTE: MINIMU PERMIT F IS $35.00
err
SIGNATURE
/
SUBTOTAL
= AMOUNT
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
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
PLUS: PROCESSING FEE
/o
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_$ 37
West 1303kBroadwav Avenue Spokane �WAin99260 Safety 09) 456-3675