1989, 09-22 Permit App: 89003560 Water HeaterMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: S. 3DII n1.06-00
CITY/STATE/ZIP: DLUAL 1.OR- -in`i W (e PARCEL NUMBER:
OWNER: it thQS VOJL (11�6�� PHONE NUMBER: h1 Z4-702_
MAILING"ADDRESS: ' SArvt AS
7 p� (Street)
CONTRACTOR: ar-t&d& V'Ji C� LICENSE
�0 lUl J PHONE NUMBER: 535
(City/State) (Zip)
NUMBER:MK RILARP IIoBQ
MAILING ADDRESS: 1; 14104 Obit
(Street)
Vans), WA cA
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
UESCR1YTiON
= AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIPING (5 OR MORE. EACH:)
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 &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE TT moon
CLOTHES DRYER
RANGE
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
x$10.00
x 25.00
x 10.00
x 12.00
x 15.00
x 4.00
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 50.00
x100.00
x 50.00
x100.00
x 12.00
x 15.00
NOTE:
SIGNATURE
MINIMUM PERMIT FEE IS $35.00
0011
1 1po'kane Coulity Pkpartment of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
SUBTOTAL
$ )0•DO
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE