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1992, 02-20 Permit App: 92000912 Gas Log, Piping MECHANICAL PERMIT APPLICATION FORM cInformation Works eetJOB STREET ADDRESS: ( G // CITY/STATE/ZIP: , , � 97?—4!- PARCEL NUMBER: OWNER: PHONE NUMBER: MAILING ADDRESS: (Street) ' A� (City/State) (Zip) CONTRACTOR: /i��/'�' �7 / ICENSE NUMBER: CCS GiF'Nil/f ' PHON NUMBER:�S'�9> ���G MAILING ADDRESS: LU .2 2 / y C ��l� � P? U? (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPAR) TE SYSTEMS) x 10.00 = 2 .00 = ERT » ::`: .,, <' '«<`' >.:::>::::: ..;;::: x 5 GAS WATER HEATER x 10.00 = GAS EQUipMENT«00,000 BTU (INCLUiSS x 12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = • 1.0...0000000 0 = GAS piPING(EA 01.1 .... ........ ::.;:.;::.;;;....::....... x 0 BOILER/REFRIG 1-100M BTU x 12.00 = x20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = ....:::.....:::.. :::: »OILER/RSI` 110.1,40.........:;:f.,'"-.--1,0001-10M BTU `>::::::: ' ;:::::"`::...... x 35.00 = BOILER/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 Pt, Me ACRCONDITIONER 15-30TONS 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 = 1 LE EVAP .RAT IV:E. OO ..... .S ........;::;` :»`:::: ::::€:>;::<> ; € ::::' :>::: <:;::;; ;: TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) xx 500..0000 = = x 10.00 = CLOTHES DRYER x 10.00 = x 10.00 = GAS BOG:... -- j x 10.00 = l v c MISCELLANEOUS(NOT COVERED.ELSEWHERi= . : x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ULINSTED CA$APPLIANCE>400,000 B'f't) :< .;: . : x100.00= . USED APPLIANCE<400,000 BTU x 50.00 = USED APPLIANCE 7400,000 BTU.... x100.00= AIR HANDLER<10,000 CFM x 12.00 = AIR;HANDLER>10,000 CFM ':` .; > :.:< .. .. x 15.00 = SUBTOTAL $ PLUS: PROCESSING FEE +$ 25.00 =$ 3t NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL FEE PERMITDUE / SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675