1992, 08-20 Permit App: 92006690 Furnace, PipingMEC,HANMCAL RERMitAPPL.ICATION FORM
Information Worksheet
JOB STREET ADDRESS: C6' . a 7/ g 3 Sr C(
CITY/STATE/ZIP: 5 pok&n.e 9va/v
QWNER: E R k.ello IMAULING ADDRESS: 3�jnr-c
(Street)
CONTRACTOR: MARTIN SHEET METAL INC
((LE S) PK
829
PARCEL NUMBER:
PHONE NUMBER:
55ei1.266/
9?? Q 58°
MAILING ADDRESS:BLDG 103 SPOKANE INDUSTRIAL
(Street)
DESCRIPTION
(City/State) (Zip)
LICENSE NUMBER:MA RT IS M170KW
PHONE NUMBER: 924-8088 / FAX .924=1688
PARK SPOKANE, WA
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK_�'4�:ti!`CRK (SEPARATEpSYSTEMS)
Wthatrffalge 9'£I}ts"'u iiYcvy yy`o`.,a.
GAS WATER HEATER i
/ GAS EQUIPMENT+100,000 BTU
•GAS PIPING'(
BOILER/REFRIG 1-100M BTU
8Q14)IEFtICa 7D
BOILER/REFRIG 501-1,000M BTU
BOiLER/REFRIG 7 OOO1-i 75OM BTU
BOILER/REFRI�G+1,750M BTU
HAAT PUMP& AIR CONDITIONaR 0 3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HE&T PUMP & AIR CONDITIONER 15 30'TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
VENTILATING FANS
.mA;Xiafm.ro
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
M SCOELCANEOUS{NQzT GO�ERED ELSEWfiE
UNLISTED GAS APPLIANCE <400,000 BTU
.ULIt4StE17,GAS,APPLIANCE 4O0,00b B U)s
USED APPLIANCE <400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >7 0 00O CFM r
NOT: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
j4jjPeSdC-
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
99216-1609
PP)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x10.00 =
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 =
1a
1
_,.. ,:.c.. ^r,,
.
,:-, . -.
SUBTOTAL
$ 1 3 -
PLUS: PROCESSING FEE
+5 25.00
EQUALS: TOTAL PERMIT
FEE DUE •
Cep -
= 5 3 0