1992, 11-30 Permit Aopp: 92010489 Water Heater, PipingJOB STREET ADDRESS:
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
/.•‘/g /2(646e PO
CITY/STAT ZIP: ak-Atme U)A . 99206 PARCEL NUMBER:
OWNER: crr
MAILING ADDRESS:
CONTRACTOR:
PHONE NUMBER: W7 Z )36
(Street) (City/State) (Zip)
LICENSE NUMBER: Mai T E PI 1S CJ
PHONE NUMBER: S09 - Soo 0
MAILING ADDRESS. F at -a 6. LL) j4
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
GAS EQUIPMENT BTU (INCLUDES
EQUIPMENT +100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
0.0ICEIIMEN11011101#60.10K:tU
BOILER/REFRIG 501-1,000M BTU
BOILEFI/REFRIG +1,750M BTU
HAT PUMP &AIR CONDITIONR 0-3 TONS
..•
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HAT PUMP & AIR CONDIT1ONER .f50 TONS
VENTILATING FANS
TYPEI HOOD (PER 12' OR 12' PTN. OF HOOD) •
CLOTHES DRYER
GAS LOG
MISCELLANEOUS (NOT COVEflb ELSEWHERE.•
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANCE >400,000 BTUUSED APPLIANCE <400,000 BTU
titttf.:*roLIANot$4.0ibotrBTU
AIR HANDLER <10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
NUMBER
OF UNITS
X EACH
UNIT
OS AMOUNT
x10.00 =
x 25.00 =
x10.00 =
x12.00 -
x 15.00 =
X 1.00 15
x 12.00 or
x 20.00 =
x 25.00 =
x35.00 =
x 60.00 ra
x 12.00 =
x20.00 =
x 25.00 =
x 35.00 =
x 60.00 air
x10.00 =
x10.00 v=
x 50.00 =
x10.00 =
x10.00 ate
x10.00 =
x10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 B2
x100.00 =
x 12.00 32
x 15.00 =
,'g. C4'
/
i . 017
.
SUBTOTAL
$ 0 . a'
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675