1993, 04-30 Permit App: 93003089 Gas Stove, PipingLA. �.ot° (0 MECHANICAL Pk ERMIT AP?LIGATION FORM 93.3
l(albec-0.n t (a ii -a. -29,g le In, rmationWorksheet
JOB STREET ADDRESS: 3 , r)8/,2 A)eeoD/L si peia e a 4» of
CITY/STATE/ZIP: kaAJ e /,t Jr? PARCEL NUMBER:
OWNER: 1;0 Ce HE- PHONE NUMBER:
MAILING ADDRESS: Sa si P
(Street) (City/State) (Zip)
CONTRACTOR: /�1r7Yl�(ier )AanaG,C l c LICENSE NUMBER: zA7ie/far / P1
PHONE NUMBER: 536,-Cf,S6/
MAILING ADDRESS: E. /iPg4n- n kane (1.00 9 70x0.
(Street)
City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT ir. ^::
GAS WATER HEATER
GAS EQUIPMENT <100,000 BTU (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET).::'::':': :
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 101=500M.BTU::
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG.1;0001L1,750M,BTU.,
BOILER/REFRIG +1,750M BTU
.HEAT PUMP &AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP.B, AIR CONDITIONER 15-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
:HEAT PUMP & AIR CONDITIONER+50 TONS .
VENTILATING FANS
EVAPORATIV.ECOOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPEIIHOOD'-:; °;s.:::°_at'' :'.':; :;' ::.s°:`:_: ;..'
CLOTHES DRYER
GAS LOG
GQ
MISCELLANEOUS (NOT COVERED:ELSEWHERE Ue
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 .'. 6i(
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE,�/�1
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 =
x10.00 =
x 50.00 =
x100.00 •
x 50.00 .
x100.00 •
x 12,00 .
x 15.00 •
/
/, 00
/
/0, on
SUBTOTAL
$ //, n o
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ 3o,00
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675