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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