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1989, 04-18 Permit App: 89000897 Water Heater MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: � � CITY/STATE/ZIP: Lon 6N?/,-- PARCEL NUMBER: OWNER: (� {t� i- (� L U� vyil ��vlI PHONE NUMBER: - fd--6I MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: ‘-.),(27LA.,../) _ -22e. ;; 't, e.C) LICENSE NUMBER: PHONE NUMBER: j-1/7( - 320 MAILING ADDRESS: ' ,D . )r / - '9922-6) (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT = AMOUNT DUCTWORK SYSTEM x$ 6.50 = WOODSTOVE/INSERT x 10. 00 = GAS WATER HEATER _ _ _ / x 6. 50 = (,5?? HEATING EQUIPMENT <100, 000 BTU x 9 . 00 = HEATING EQUIPMENT +100, 000 BTU x 11. 00 = GAS PIPING (EACH OUTLET: ) x . 50 = REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 9 . 00 = REFRIG 101-500M BTU x 16. 50 = REFRIG 501-1, 000M BTU x 22 . 50 = REFRIG 1, 001-1, 750M BTU x 33 . 50 = REFRIG +1,750M BTU x 56. 00 = HEAT PUMP & AIR CONDITIONER 0-3 TONS _ - x 9. 00 = HEAT PUMP & AIR CONDITIONER 3-15 TONS _ x 16. 50 = HEAT PUMP & AIR CONDITIONER 15-30 TONS _ x 22 . 50 = HEAT PUMP & AIR CONDITIONER 30-50 TONS _ x 33 . 50 = HEAT PUMP & AIR CONDITIONER +50 TONS _ x 56. 00 = VENTILATING FANS _ x 4 . 50 = EVAPORATIVE COOLERS x 6. 50 = HOODS x 6. 50 = CLOTHES DRYER x 6. 50 = RANGE x 6. 50 = GAS LOG x 6. 50 = UNLISTED GAS APPLIANCE x 20. 00 = AIR HANDLER - 10, 000 CFM x 9 . 00 = SUBTOTAL $ PLUS: PROCESSING FEE + $ 15. 00 EQUALS: TOTAL PERMIT NOTE: MINIMUM PERMIT FEE IS $20.00 FEE DUE _ $ l Signature U _ �4I'L Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675