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1992, 07-07 Permit App: 92005051 Water Heater MECHANICAL PERMIT APPLICATION FORM . u)I ` Informat,on,Worksheet J JOB STREET ADDRESS: /i 70 -Sg.)/ vItoLt/ 1_,'? 8-7 CITY/STATE/ZIP: See/ v-'-e WIr FP'2o PARCEL NUMBER: L-( J `7 , 6 7( )7 OWNER: S© / til'/( PHONE NUMBER: 92-5 - $/PO y MAILING ADDRESS: _.,-7 1t--`-e • (Street) (City/State) (Zip) CONTRACTOR: i-1 -' - ,v, r_ # , LICENSE NUMBER:Al/G'-IYS5><rC9oiel� Al /� c PHONE NUMBER: t 2-2- ^ _z©9 MAILING ADDRESS: 2/7/ !l ( l�,t C.- /o,i -9(0/4"2., 9 2-07 (Street) y/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = WOOt3STOVE/INSERT >; x 25.00 GAS WATER HEATER f x 10.00 = /ea * ' GAS';EQUIPMENT:<i00000 BTU(INC(UDES x 12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = r.'0WPIPW.P..(g#.,1001.•X.471liakiiiiii'iii,Eigiii!iiiiiiiiiIiMiiiiiiiiEigi.iiiiliiiii!iix 1.00 = BOILER/REFRIG 1-100M BTU x 12.00 = BOILER/REFRIG 101-500M B'T J x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = BOILER/REFRIG 1`,0001:1,750M BTU , x 35.00 = BOILER/REFRIG +1,750M BTU x 60.00 = HEAT PUMP&AIR CONDITIONER 0-3 TONS x 12.00 = HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = HEAT PUMP I AIR CONDITIONER 5-30 TONS x 25.00 = HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 = HEAT PUMP&AIR CONDITIONER+50 TONS x 60.00 = VENTILATING FANS x 10.00 = EVAPORATIVE COOLERS . x 10.00 = : TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = T1(PE II HOOD x 10.00 = CLOTHES DRYER x 10.00 = RANGE x 10.00 = GAS LOG x 10.00 = MISCELLANEOUS(NOT COVERED t LSEWHERE x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ULINSTED GAS APPLIANCE>400,000 BTU x100.00= USED APPLIANCE<400,000 BTU x 50.00 = USEt AP LIANCE ..400,000 BTU ; xl 00.00 = AIR HANDLER<10,000 CFM x 12.00 = AIR HANDLER> 0,000 CFM x 15.00 = SUBTOTAL $ fid.old PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE =$ 35.0-0 SIGNATURE -;I' - .,, -,- Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675