1991, 10-17 Permit App: 91006889 Furnace, PipingMECHANICAL- PERMIT APPLICATION FORM
n Information Worksheet
JOB STREET ADDRESS: 2 %.-2 6( U .. 0/A'eLs-'GI -
CITY/STATE/ZIP; Ct'otn X /11,7. PARCEL NUMBER: e --e5111 - // 111
OWNER: ,'t 2/21 /5/ r'S PHONE NUMBER: `/2 i4 7=R(7
MAILING ADDRESS: <-29/ner
(Street) (City/State)
CONTRACTOR: Heat Transfer Inc. LICENSE NUMBER: Heatti-1881n
PHONE NUMBER: 328-3400
MAILING ADDRESS: N. 1008 Ruby Spokane, WA 99202
(ZiP)
(Street) •
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
GAS EQUIPMENT :<100,000 BTU,:(INCLUDESD
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING EA:OUTLE_
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG..101500M
BOILER/REFRIG 501-1,000M BTU
'BOILER/REFRIG "1;0001-1;750M:.BTU:'':
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0-3 TONS :':
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP& AIR CONDITIONER 15L30 TONS'
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR CONDITIONER+50 TONS
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
RANGE
GAS LOG
MISLELI.ANEON NOTcOVERED ELSEWI-IEFiE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS_ APPLIANCE>400,000. BTU::.,,
USED APPLIANCE <400,000 BTU
>USEb :APPLIANCE �400;000'e
AIR HANDLER <10,000 CFM
AIR: HANDLER°>1.0,000:PFM ::1 -
NOTE:
1 -
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x25.00 =
x 10.00 =
.
J
x12.00=
JZJ7
x15.00 =
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 =
x50.00=,.
x100.00 =
x 12.00 =
x 15.00 =
J
/ KC%
SUBTOTAL
$ Ja%
PLUS: PROCESSING FEE .
+ $ 25.00
EQUALS: TOTAL PERMIT�?
FEE DUE
��
= $ V
SEP 2 3 1991
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675