1992, 12-10 Permit App: 92010828 Water Heater, PipingMECHANICAL
JOB STREET ADDRESS: I 11-5112_
PERMIT APPLICATION FORM
iM-rmaUon Worksheet
0\z_ \ 0828
nFrl
CITY/STATE/ZIP: prkinP
OWNER: 3e“ )erjo
PARCEL NUMBER:
PHONE NUMBER: el 2Fr. Bryn
MAILING ADDRESS: E- ik-'112. riumpLc.
(Street) (City/State) (Zip)
CONTRACTOR:D'I nC, LICENSE NUMBER GOL1) Stn 2q0
MAILING ADDRESS.
E-.
so • • '
PHONE NUMBER: S'S" -S q
* • o. a,
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
gtoptimmisowisa. .44k"I:15%.64-1#10011164
GAS WATER HEATER
KAINISOMINOVAINE
GAS EQUIPMENT +100,000 BTU DUCTWORK)
.,1120
BOILER/REFRIG 1-100M BTU
VEMATERNAW
BOILER/REFRIG 501-1,000M BTU
KOMME:gtrgarAT
BOILER/REFRIG +1,750M BTU
L.
V.,
•
f.' 4445,1
HEAT PUMP & AIR CONDITIONER 3-16 TONS
'Y
HEAT PUMP & AIR CONDITIONER 30-50 TONS
•' `41i
vh) -;9•;4.
VENTILATING FANS
kc
TYPE I HOOD (PER 12' OR 12' PTN, OF HOOD
CLOTHES DRYER
•
GAS LOG
NWOMMINI:MOOPIKNI:
UNLISTED GAS APPLIANCE <400,000 BTU
WINIMPAWIROW,K.Matafn
USED APPLIANCE <400,000 BTU
7,MM:
AIR HANDLER <10,000 CFM
gat•P:
-
m§..?mref
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATUR
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x10.00 =
x 25.00 =
x10.00 om
x1200 -
x 15.00 ors
x1.00 -
x 12.00 I.
x 20.00 =
x 25.00 =
x35.00 I.
x60.00
x 12.00 =
x20.00 at
x25.00 an
x 35.00 =
x 60.00 al
x10.00 mg
x10.00 =
x50.00 =
x10.00 k.
x10.00 =
x10.00 =
x10.00 rl
x 1 0.00 .
x 50,00 =
x100.00 .
x60,00 =
x100.00 =
x12.00 =
x 16.00 =
1 D - ob
1
'
SUBTOTAL
FEE
$ II • Qs)
+ $ 25.00
PLUS: PROCESSING
EQUALS: TOTAL PERMIT
FEE DUE
. $ 31s:co
Jbk67 CLAD -S-a41-3d-91F*426 A ir L,INC •
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675