1993, 04-13 Permit App: 93002455 Mechanical Fixtures 6L - T3- Lt 55
�Z MECHANICAL PERMIT APPLICATION FORM
� � 6 -\ L
� �� a- Information Worksheet 50
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JOB STREET ADDRESS: 5118 Snnth VanMartar
CITY/STATE/ZIP: Spokane WA 99206 PARCEL NUMBER: 57E►N H l -4"41�,
OWNER: Joseph E Mirich PHONE NUMBER: 509-928-5693
MAILING ADDRESS• 508 South VanMarter Spokane WA 99206
• (Street) (City/State) (Zip)
CONTRACTOR: Steinmetz Heating & A/CLICENSE NUMBER: STEINFA147KF
PHONE NUMBER: 509-922-2034
MAILING ADDRESS: North 2114 Pines Ste #3 Spokane WA 99206
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT = AMOUNT
DUCTWORK SYSTEM x$10.00 =
WOODSTOV,,E/INSERT x 25.00 =
GAS WATER HEATER I x 10.00 = IO.co
HEATING EQUIPMENT <100,000 BTU I x 12.00 = 12. . 00
HEATING EQUIPMENT +100,000 BTU x 15.00 =
GAS PIPING .(EA .OUTLET) 3 x 1.00 = 3. co
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12.00 =
REFRIG 101-500M .BTU • x 20.00
REFRIG 501-1,000M BTU x 25.00 =
REFRIG 1,001-1,750M BTU x 35.00 =
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 & AIR CONDITIONER 15-30 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 =
TYPE II HOOD x 10.00 =
CLOTHES DRYER x 10.00 =
RANGE x 10.00 =
GAS LOG x 10.00 =
MISCELLANEOUS (NOT COVERED ELSEWHERE)_ x 10.00 =
UNLISTED GAS APPLIANCE <400,000 BTU_ _ x 50.00 =
UNLISTED GAS APPLIANCE >400,000 BTU_ _ x100.00 =
USED APPLIANCE <400,000 BTU x 50.00 =
USED APPLIANCE >400,000 BTU x100. 00 =
AIR HANDLER <16, 000 CFM x 12 . 00 =
AIR HANDLER >10, 000 CFM x 15. 00 =
SUBTOTAL $ aS.aD
PLUS : PROCESSING FEE + $ 25.00
EQUALS : TOTAL PERMIT~
NOTE: MINIM id, PERMIT FEE IS $35. 00 _ FEE DUE _ $ SD.o �
SIGNATURE try '
Spokan County Department of Building_ and Safety
West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675