1992, 09-17 Permit App: 92007761 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM C - 7 /LP
r q� / Information/yWorksheet q
JOB STREET ADDRESS: C . /J `72Ci t ' 1 k Lae"
CITY/STATE/ZIP: Gi l moi 0,(14 `‘q Q ‘ a PARCEL NUMBER:
OWNER: f('lN TR' PW PHONE NUMBER: Q.1I - 3011 �
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: Heat Transfer Inc. LICENSE NUMBER: Heatti-1881n
MAILING ADDRESS: N. 1008 Ruby
PHONE NUMBER: 328-3400
Spokane, WA 99202
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS: EQUIPMENT<100,000
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING (EAOUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG;101-SOOM$TU --__
BOILER/REFRIG 501-1,000M BTU
°BOILER/REFRIG1 0001=1',750M:BTU
BOILER/REFRIG +1,750M BTU
HEAT PUMP:&:AIR:CONDITIONER_0-3: TONS:
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP &AIR CONDITIONER 15-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR CONDITIONER +50 TONS-
VENTILATING FANS
EVAPORATIVE: COOLERS:. -:
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II
CLOTHES DRYER
RANGE:
GAS LOG
MIISCELLAtJEOUS(NOTCOVERED _ELSEWHERE.a` `:' :M
UNLISTED GAS APPLIANCE <400,000 BTU
;ULINSTED.GAS_APPLIANCE:>400,000BTU.:
USED APPLIANCE <400,000 BTU
USgo::APPL1ANGE.>4.904000 BTtFsfs,
AIR HANDLER <10,000 CFM RECEIVED
AIR HANDLER:>10 000:CFM:.
SEp r4 1°82
BUILDING & SAFETY
NOTE: MINIMUM PERMIT FEE IS $35.
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
x12.00 =
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 =
x10.00 =
x 50.00 =
x100.00 =
x 50.00 = -
x100.00 =
x 12.00 =
/0, Or)
'
/,�,0n
•
a-.0
x 15.00 =
SUBTOTAL
$ .Z.<l.00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_$ 5/1..Do
Spokane rd•unty Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675