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1992, 02-12 Permit App: 92000764 Wood Stove
MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: £• ) q Divi q ,O; XOV1 CITY/STATE/ZIP: C7 r-teanAG/t5 LUQ 9401(, PARCEL NUMBER: OWNER: De Iof R (100d LA), 1 PHONE NUMBER: 67ai "y/13 MAILING ADDRESS: CONTRACTOR (Street) (City/State) (Zip) l! j,iC=,.Ifh..? LICENSE NUMBER: I -:-((.C• /('.I-73!=bu(. PHONE NUMBER: (_`.i(')ri) Ch)(,-- 'S"7) ) MAILING ADDRESS: r (131E) _33, r1<;L•<S. `,;..-r:K.=ii.ie- i,;i:=i `l%L"C:(f (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER OF UNITS DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) .. . .. >WOODSTOVEANSER....:.:..::::::',,,:.:.- GAS WATER HEATER GAS: EQUIPMENT<100,000 BTU _(INCLUDES GAS EQUIPMENT+100,000 BTU DUCTWORK) :GAS;PIPING`.(EAOUTLET) ..... BOILER/REFRIG 1-100M ;BOIL i /REFFiIG'f 01=500M em :'_'::'°''` r....v BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG+1,750M BTU-`;" HEAT PUMP:.`& AIR: CONDITIONER o-3 TOt3S.:;:_::i:: HEAT PUMP & AIR CONDITIONER 3-15 TONS----- - HEATtiPUMP:& AIR:CONDITIONERi15-30'TONS‘;: HEAT PUMP & AIR CONDITIONER 30-50 TONS -- - HEAT PUMP°&`AIR-CONDITIONER +50°TONS VENTILATING FANS XEACH UNIT = AMOUNT !EVAPORATIVE. COOLERS:: ::.`: TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) - TYPE II HOOD .:;;T:' CLOTHES DRYER GAS LOG M!SC.=LLANFir) i!^ UN! ISTRD GAS AP=L1°NCE (400.000 ET' ' AFPLIAN.;E c40'ETU,COU ET ........ .., USED;inPPLIC.NCE>400,000 BTU:_' :? AIR HANDLER <10.000 CFM x 10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x 1.00 = x 12.00 x 2000 x 25.00 = x 35.00 = . x60.00'_ - x 12.00 x 20.00 x 25.00 =. x35.00 = x 60.00 = x 10.00 = x 10.00 = x 50.00 = x 10.00 =• x 10.00 = x 10.00 = x 10.00 = ::10.011 _ :100.0o = :: 50.00 = xi00.00 = x 12.00 = x 15.00 = 025-92 - " IMUA FERWi. _- 1S C25.00 FE.C;;ESSING FEE IEQUALS: TOTAL PERMIT FEE DUE s.N;.TURE Spokane County Division of Buildings 25.0: