1992, 06-01 Permit App: 92003898 Water Heaterlam A MECHANICAL PERMIT APPLICATION FORM
�4� �� , Ld 1 Information Worksheet
JOB STREET ADDRESS: 11009 East Maxwell Avenue
°I a 3s`r8
35E
CITY/STATE/ZIP: Spokane, WA 99206 PARCEL NUMBER:
OWNER: Marge Snider PHONE NUMBER: (509) 926-0686
MAILING ADDRESS: 11009 East Maxwell Avenue _apokana. WA QQ20S
(Street) (City/State) (Zip)
CONTRACTOR: Steinmetz Heating & A/C LICENSE NUMBER: STEINHA147KF
PHONE NUMBER: (509) 922-2034
MAILING ADDRESS: 2114 North Pines Road, Suite 3
(Street)
Spokane, WA 99206
(City/State) (Zip)
MECHANICAL
DESCRIPTION
WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS IUNIT
DUCTWORK SYSTEM
WOODSTOV,E/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING:(EA.OUTLET)
REFRIG 1-100M BTUs(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 -Se
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
1
= 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 =
10.00
NOTE: MINIMUM PERMIT FEE IS '$35.00
SIGNATURE 5 371(2. 'yap
SUBTOTAL
$ 10.00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_ $
35.00
CK #3958
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675