1992, 04-14 Permit App: 92002508 Water Heater, PipingD ttc 1ST Aact-.
JOB STREET ADDRESS: 67107 �' i oit fro nC y
CITY/STATE/ZIP: 5 -pc. Kms+. -L/ wa Q9Z/L PARCEL NUMBER:
OWNER: Many L.-ohnjoN PHONE NUMBER: RP6-9S36
MAILING ADDRESS: 7%7 E. /2,1, S fr&e 20,41 r72 72 -
(Street) (City/State) (Zip)
CONTRACTOR: So( LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(Zip)
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
(D- SOF"
7q7
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT:_, ` `°"':.• ';.:.'"r;`::':" :..:
GAS WATER HEATER
GAS, EQUIPMENT <100,000 BTU (INCLUDES ,',
GAS EQUIPMENT+100,000 BTU DUCTWORK)
iGAS;PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 101-500M BTU
BOILER/REFRIG 501-1,000M BTU
,BOILER/REFRIG 1,0001-1,750M 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 ,HOOD •
CLOTHES DRYER
RANGE..
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED 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
NOTE: MINIMUM PERMIT FEE IS $35.00
NUMBER
OF UNITS
X EACH
UNIT
= 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
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
•
f
/o. Cp
i
SUBTOTAL
$ / /, o o
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 3 0.00
SIGNATURE '�7� /c7.r�
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675