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1992, 10-19 Permit App: 92008987 Water Heater, Piping MECHANICAL PERMtrAPPtICATION FORM �'; { �, Ir �a«+?' '$ „a � r �'`, 4 �F ' t '3'7.,t 8 t q > 1'1 t' , Information Worksheet !� `r}1 , t r�'1 ° ,.';',111'1,.!"..V1-,1.,"•,. ,,,,14.14,r11-$;:,.t "( :7t1 s,^7 ' �, _ ) -,-,t-, 1 k h er�e4 ,l , t „ .'-'f ;JOB A STREET ADDRESS n �� kiti [�aS Tcl *hr .1{tarn s...;,.,;, c .. 4'i PARCEL NUMBER: ,�"t l , k , r � r , , . �, t 0^• -- -«. _ , ... . ....-_ _ _. .-.1. 1.t ,. ' W e !' ',,;I f.1 {,l10AMt.,i ,„trtx t { �' kiiii 1 ' OWNER: ,<�j�.� «\ F `1 ��-- PHONE NUMBER: g.2.4 `�4 }�'"�'' '"'` Ak , { k MAILING ADDRESS: , " F. w,, , ., A 21f ....i (Stree - ... , . - ' . «« . (City/State) F 4 ; (Zip) 2,. • :,'/, ; ,',`: (r t �“. •. � � , yint al { « i P CONTRACTOR: ifli,c.,e/ / ,:,1 LICENSE NUMBER: � i 'aT ,-,�, Z . ' r , 1 PHONE NUMBER: SO -7.2. z C " ixm MAILING '-ADDRESS: E 1/80.2 i' - n.sti e 1d ��1� L ) t .�--C 4 } �:, 1 ; ' (Street) ,,' ., (City/State) :,(Zip) ,;,' .^, �� r ',0'',1'; tr fA:., X 1.7 Rt jW.t+. fa Y C MECHANICAL WORKSHEET/FEE SCHEDULE ' ) ' ) , �'tf if' r NUMBER X EACH 'r, ; .:',i. " ' ' DESCRIPTION OF UNITSUNIT -,. ,. AMOUNT DUCTWORK SYSTEM x$10.00 :',= WOODSTOVE/INSERT x 25.00 GAS WATER HEATER / x 10.00 /0 .*-,-- ,.., HEATING EQUIPMENT; <100, 000 BTU x .12.00 ','HEATING' EQUIPMENT. +100,000 BTUx, 15. 00 „= 'GAS: PIPING ;(1 - 4 ' OUTLETS) _ - - - x 4 . 00 '` GAS`PI$ING (5 OR MORE. EACH: ) x 1.00 '_ / • ,- 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 = r,1 REFRIG 1,001-1,750M BTU x 35. 00 ".. REFRIG +1,750M BTU x 60.00 ,= ' p'` i HEAT PUMP & AIR, CONDITIONER 0-3 TONS _ _ x 12.00 ;_ _' HEAT PUMP' &' AIR CONDITIONER 3-15 TONS x 20.00 �,_ },' ;' HEAT & AIR CONDITIONER 15-30 TONS _ x 25. 00 : -' HEATPUMP & AIR CONDITIONER: 30-50 TONS x. 35. 00. HEAT PUMP & AIR CONDITIONER +50 TONS x 60.00 ' " '' ? � VENTILATING FANS • . - x 10. 00 '_ • u' h EVAPORATIVE _.COOLERS • x 10.00 TYPE -I` HOOD (PER .12 ' OR 12 ' PTN. OF. HOOD) x 50.. 00'"= ,; t ,5' TYPE II HOOD x 10. 00i7= ' ` CLOTHES', DRYER x 10.00 ht RANGE x 10. 00 X , r GAS LOG • x 10. 00. _ ,. '`'MISCELLANEOUS (NOT COVERED ELSEWHERE)_ _ x 10. 00 'i ' j 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 := ` t ' - AIR HANDLER <10, 000 CFM - x 12 .004 AIR HANDLER >10,000 CFM x 15. 00 = 1, r SUBTOTAL .„1 $ riftib '4 1 ' ' ' 't , { i PLUS: PROCESSING FEE + $t:'i x,25 r00+, 'i ,j*t' t,, r - '{ EQUALS: TOTAL PERMIT 1,a44:4111110,„ `'k �;` ' . -- # `° kir NOT: NIMU PERM T FEE IS $35.00 FEE DUE .! $ }. ,., SIGNATURE lb. or �� __ it' • , ``r''e rte l;r, 1. °n : �.., 1 1 'i;''.:r Spokane County Department of Building and Safety , ,; ,-,,,,,,,,,i ,,J t p West 1303 Broadway Avenue Spokane, WA 99260 (5 9) 456-3675 �f A ` 1