1992, 01-30 Permit App: 92000544 Gas Log, PipingtoO\-\,
}. ' MECHANICAL PEWIT APPLICATION FORM
ON\333 Nil d\ sntfcrmation
JOB STREET ADDRESS: E - 9 70'7
•
Worksheet
�a 54'1
CITY/STATE/ZIP: S/�7 !,,,;-
OWNER:
MAILING ADDRESS:
CONTRACTOR:
MAILING ADDRESS:
PARCEL NUMBER:
PHONE NUMBER:
(Street)
SMITH HEATING_,
E.102 NORA
SPOKANE, WA 99207
(509) 328-4431
WAYNESH258NJ
(Street)
(City/State) (Zip)
LICENSE NUMBER:
PHONE NUMBER:
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
OF UNITS BER XUNITH
DESCRIPTION
'DUCTWORK SYSTEM
WOODSTOVZ/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIVING (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 & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
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
1
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 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
= AMOUNT
fdy
/0
NOTE: MINIMUM PERMIT FEE IS $35.00
Spokane County Department of Ruildinn and Snfatu
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 3ctif/