1992, 11-23 Permit App: 92010221 Fireplace, Piping1--1) S. -2 --MECHANICAL PEWIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: 824 N. Woodruff
CITY/STATE/ZIP: Spokane,Wa 99201 PARCEL NUMBER:
foaaf
Li sq
OWNER: Ed Schaff
MAILING ADDRESS:
(SAME)
(Street)
PHONE NUMBER: (509) 926-7896
(City/State) (Zip)
CONTRACTOR: Steinmetz Heating & A/C LICENSE NUMBER: STEINMA147KF
MAILING ADDRESS:
N. 2114 Pines Rd.
PHONE NUMBER: (509) 922-2034
(Street)
Spokane WA 99206
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UTNIT
DUCTWORK SYSTEM
WOODSTOVE/INSERT _ c 44 _eJe_,Q LacAL
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING ,(EA.OUTLET)
REFRIG 1-100M BTU 4NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU .,
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
0-3 TONS _
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG_
MISCELLANEOUS (NOT COVERED ELSEWHERE)_
UNLISTED GAS APPLIANCE <400,000 BTU_ _
UNLISTED GAS APPLIANCE >400,000 BTU_ _
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
1
SUBTOTAL
x$10.00 =
x 25.00 =
x 10.00 =
x12.00 =
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 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
FEE DUE
= AMOUNT
ZS,er s
10. 00
+ $ 25.00
= $T
cklt 4553 co
Spokane County Department of Building_ and Safety
West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675