1990, 04-25 Permit App: 90001655 Water Heater MECHANICAL PERMIT APPLICATION FORM /4/-
Information
5Information Worksheet
JOB STREET ADDRESS:
CITY/STATE/ZIP: �i ` 4?t <</„;� 1.APARCEL NUMBER:
a�ppo,
OWNER: /L , ti(1.A.1 1.1 A (Lk, PHONE NUMBER:
MAILING ADDRESS: 6-/t( "- C I � ,= �( i `'
(Street) (City/State) (Zip)
CONTRACTOR-"--�\ v-c•-C kid- ik) LICENSE NUMBER:
PHONE NUMBER: «"")-- C� 55
MAILING ADDRESS: 7r c 1-e. r 02C .1
(StI eet) (City/State) (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 = /® , f`a U>
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
$
eTP PLUS: PROCESSIPIG FEE + $ 25. 00
EQUALS: TOTAL PERMIT
NOTE: M ISI �•E' IS $35.00 FEE DUE = $ r3
SIGNATURE _ , ! -
AIRO
Spokane ' my Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675