1992, 11-24 Permit App: 92010370 Fireplace, PipingJOB STREET ADDRESS:
CITY/STATE/ZIP: . 1L
OWNER: -JGti/L
MECHANICAL PERMIT APPLICATION FORMo
'Information Worksheet
(-,4ir(L 2v(occi
PARCEL NUMBER:
PHONE NUMBER: 9-;R- 763.5Z
MAILING ADDRESS:
CONTRACTOR:
(Street)
1.,9Y//%
(City/State) (Zip)
LICENSE NUMBER:_ 46 �k/P C`_ i 2/ ,)1'n
PHONE NUMBER:
MAILING ADDRESS: 1-) /: LI)c-• -X /"iil.Ci lZi 0,6 e t4.)0
(City/State) (Zip)
(Street)
MECHANICAL WORK
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
GAS EQUIPMENT < 00 000 BTU {INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
BC?:ILER/RE
BOILER/REFRIG 501-1,000M BTU
SOILER/REF IG 110001.1, 0M BTU <`: >
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR cNDITIONER 0 S TONS
HEAT PUMP AIR CONDITIONER 3-15 TONS
HEAT ? MP 8� AIRCONDITIONER 15-30 TONS:
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP Ate CONDITIONER +50TONS
VENTILATING FANS
EVAPORATIVE COOLERS ::
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
:FRAN C
Gc:
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED +GAS.APPLIANCE 7400,000. BTl1.:....:
::......:.:.:..:...:......:.:.....:.........:.....:...............:..::.............:..:.................::..........
USED APPLIANCE <400,000 BTU
USED AP LIANCE >400,000;: BTU•::.
AIR HANDLER <10,000 CFM
All WANDLEI••
NOTE: MINIMUM PERMIT FEE IS $35.00
i
SIGNATURE(1-tr_- �1' -r/k'-/U
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
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 =
x20.00 =
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 =
l
if e ,
/i9,1'V
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
SUBTOTAL
$ (/, OO
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
��/�
=$ ..66)