1992, 07-22 Permit App: 92005597 Water Heater, PipingDate -
71112119,
JOB STREET ADDRESS:
CITY/STAT/ZIP:
OWNER: fry
(2724
MECHANICAL PE�MIT APPLICATION FORM
Information Worksheet
MAILING ADDRESS'
9 a 5597
GINGRICH HEATING
E. 1023 - 37TH AVE.
SPOKANE, WA.
esa-nS�a
PARCEL NUMBER:
A) NY',t <9CtEs PHONE NUMBE RI 9,7 - ce 01-1 g
3c t 1,I cm ti 1c -i r L3�
(Street) _ (City/Stat) (Zip)
CONTRACTOR: .'111LSCy"'
t'c\ \kec,\‘13c LICENSE NUMBER: -G 1'1) 'i)..\; c ---N1 c_
N1toc
PHONE NUMBER: - RS2�
MAILING ADDRESS: itaa E ..3-P\ 'AV -e. 1sro Cf9C3
(Street) (City/ tate) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
�3ST731(I���i o echsg ....
GAS WATER HEATER
raaratliNS
GAS EQUIPMENT+100,000 BTU DUCTWORK)
KNEWMAROMMitr
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG+1,750M BTU
HEAT PUMP & AIR CONDITIONER 3-15 TONS
talaillAPSONgSbati
HEAT PUMP & AIR CONDITIONER 30-50 TONS
WATIMINEMBPROMOMEN
VENTILATING FANS
119410A110.10181144111311111111111. 3
R.:.
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
9,r wraUs r ,f" *
UNLISTED GAS APPLIANCE <400,000 BTU
.r:
4J;S41%rtEt N��11S kPi?t l(xSg,:z,, .Op QotY: l tea$
USED APPLIANCE <400,000 BTU
AIR HANDLER <10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x50.00 =
x100.00 =
x 12.00 =
x 15.00 =
%.40
l vt?a
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675