1989, 07-11 Permit App: 89002159 Water Heater MECHANICAL RERMLT APPLICATION FORM
Information Worksheet 4
JOB STREET ADDRESS: .24 r k)00
CITY/STATE/ZIP: , � 9g22) (,, 5j PARCEL NUMBERUq'Ct -q00�
OWNER: eit) ) PHONE NUMBER: GJ,"�'
MAILING ADDRESS: J `7 `�J06b6 D ' c-
(Street)
(Street) (Ci y/S ate) (Zip)
CONTRACTOR: 6ert , LICENSE NUMBER:
PHONE NUMBER: 4 - // 70- e. , 3
MAILING ADDRESS: � ' E3'24i'7 (J GJ izu)
Street State
(Street) (CY/iy/ ) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT = 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 BTU x 15. 00 =
GAS PIPING (1 - 4 OUTLETS) x 4 . 00 =
GAS PIING (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 =
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 <10, 000 CFM x 12 . 00 =
AIR HANDLER >10, 000 CFM x 15. 00 =
SUBTOTAL $ /fit°
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT
NOTE: MIN UM PERMIT, E IS $35.00 FEE DUE _ $ 35�
SIGNATURE �1 -
Spokane County De artment of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675