1993, 01-28 Permit App: 93000441 Water Heater i z3� MECHANICAL PERMII APPLICATION FORM
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JOB STREET ADDRESS:: Z 3 ,/
CITY/STATE/ZIP: >J a j1 E'> �C � Q ?/WPA.RCEL NUMBER:
OWNER: `Mk `S.z• ��''"L•' ' PHONE NUMBER: 5-3 v 77_5"---
MAILING
MAILING ADDRESS: &'6-/' s/If 'a-iLt�/ L� W7/' -
(Street) f(City/State) (Zip)
CONTRACTOR: ),Z7-a--k^i-r eiLiAL L LICENSE NUMBER: ---&2 32a24)/
PHONE NUMBER: -
MAILING ADDRESS: 6,4,a_ �' ��' f L� 994?
(Street) Cit /State (Zip)
City/State) ( P)
t.
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBERX EACH
DESCRIPTION OF UNITS ! UNIT l = AMOUNT
DUCTWORK SYSTEM x$10. 00 =
WOODSTOVE/INSERT x 25. 00 =
GAS WATER HEATER / x 10.00 = h9. 00
HEATING EQUIPMENT <100, 000 BTU x 12.00 =
HEATING EQUIPMENT +100, 000 ETU x 1)4-19 =
GAS PIPING (1 - -A OUTLETS) x
GAS PIRING (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) y 30.00 =
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, 0.00 CFM x 12 . 00 =
AIR HANDLER >10,000 CFM x 15.00 =
SUBTOTAL $ /6. 00
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT-
NOTE: MI IMUM • - ' ) FEE IS $35.00 FEE DUE 2: $ 3.5-`CQ-
SIGNATURE
$ c .`SIGNATURE h ;D/ --G 4) .
Spoka e C' ' ty Department of Building and Safety
!! ;i !: Broadway Avenue Spokane, WA 99260 (509) 456-3675