1989, 11-30 Permit App: 89004970 Water HeaterMECHANICAL PERMIT APPLICATION FORM
Information.. Worksheet
JOB STREET ADDRESS: id, /4' O 4/43 .
CITY/STATE/ZIP: ib s
PARCEL NUMBER:
OWNER: ONe DeeZAIP PHONE NUMBER: qt* 3,8,3.3
MAILING ADDRESS: 10. , /1/2 dd .S4
/ (Street)/(City/State) (Zip)
CONTRACTOR: 0441w ', 1,Al e % 9 +ICENSE NUMBER: 14DA/Atr -/6 Q4.
PHONE NUMBER: 5 .1146,5-V7
MAILING ADDRESS: ). /Of 4,/'15 : 0o' f 99i
(City/State) (Zip)
(Street)
FEB SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
DUCTWORK SYSTEM_
WOODSTOVE/INSERT _
-' GAS WATER HEATER_ _
HEATING EQUIPMENT -<1.075,75015 0 BTU _
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (EA OUTLET)
REFRIG 1-100M' BTU (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 & AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
VENTILATING FANS
EVAPORATIVE COOLERS_
TYPE I HOOD (PER 12' OR 12'
TYPE II HOOD
CLOTHES DRYER_
RANGE -
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
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 -
PTN. OF' HOOD)
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 =
_
04.0
.4111
p. vc�
NOTE: MINIMUM,1PE ` ,/FEE ' IS ,$35.00
S I GNATURE
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Department of Buitdin and Safety
West 1393 Broadway Avenue Spokane, WA 99260 (509) 456-3675