1993, 03-15 Permit App: 93001485 Water Heater, Piping , ... c\3- ii.-13°
MECHANICAL PERMIT APPLICATION FORM
Z
Information Worksheet I u
JOBSTREETADDRESS: 1-/`'/D7 5 . Sk.-(1wby41..
CITY/STATE/ZIP: 4.__ -wks.0 , ,.c,� 019,2-06 PARCEL NUMBER:
OWNER: 50\nv, 1---45 e--1 PHONE NUMBER: c(a1 135.,
MAILING ADDRESS:
r (Street) (City/State) (Zip)
CONTRACTOR: T i4 ) C C7/ -11i_ C•-j,/ C_ .,,J/-1---(e LICENSE NUMBER: t- 4 IC-C.% C:/(..-_-'.1 73 t:t
PHONE NUMBER: (_`C ei) cL1(.r.-'&'`.71 /
MAILING ADDRESS: E E . ,13I ( � _'.5..")r-?_ rii,P_ ,(" '"•,r_rli,1(__ Lv. c,7 LGCr
(Street) (City/State) (Zip)
._ MECHANICAL WORKSHEET/FEE. SCHEDULE
NUMBER X EACH
, DESCRIPTION OF UNITS UNIT 1 =AMOUNT
LEC o RIC/DUCTWORI<(SEPARATE SYSTEMS) ,. ,
I �� 'a.cv= 1
WOODSTOVE/Ir4SER i : : . . X 25.00 =
.GAS WATER HEATER::.:::... x 10.00 =
GAS:EQUIPMENT100;000 BTU(INCLUDES x 12-00 =
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
GAS PIpiNG (EA OUTL'-Tj j x 1.00 = /. Ob
BOILER/REFRIG 1-100M BTU --- --_. ___. - x 12.00 =
O!L:=R/RE=RIG 101 .500P.'STU - x 20.00 =
BOILER/REFRIG 501-1,000M BTU ---- x25.00=
5011R/R-EI=RIS 1: 0001---1 750M PIP, x 35.00 =
EOILERJREFRIG+1,750M BTU ` --- T =-- x 60.00 =
:-:',.7'‘..t.Pegs° &A IrR.CONDITIOI =R 0=3 t ONS. . x 12.00 =- -.-
T Pi)1.MP P:AIR CONDITIONER 3-15 TONS x 23.00 =
I,EATPUMMMiP&AiRCONDITIONER 15`.- .: : ::,:k.,„ I x25.00 =
HEAT PUMP&AIR CONDITIONER 30-50 TONS -- ' x35.00 =
HEAT PUMP&AIR CONDITIONER +50 TONS x 60.00 = .
VENTILATING FANS x 10.00 =
._V-PORAT1VE COOLERS x 10.00 =
'PE I HOOD (PER 12' OR 12' PIN. OF HOOD) x 50.00 =
TYPE II HOOD x 10.00 ---
CLOTHES
CLOTHES DRYER x 10.00 =
-, •-,f;-:,..z..- I x10.00 I
GAS LOG x 10.00 = I D , CD
I%1ISCELLANEOUS.(NO COVERED ELSEWHEREx 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINSTED ED GAS APPLIANCE_>400,000 BTU 1 x100.00=
SED APPLIANCE`100,000 BTS x 50.00
L__
USED APPLIANCE>:400,600 BTU I x100.00 =
AIR HANDLER <10,000 CFM x 12.00 =
AIR HANDLER>10,000 CFH x 15.00 =
_ L .
SUBTOTAL S /1 ,Op
`1PLUS: PROCESSING FEE ( +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT 2 ( O
FEE DUE = S _36
SIGNATURE
Spokane County Division of Buildings