1992, 07-09 Permit App: 92005115 Water Heater, Piping MECHANICAL PERMIT APPLICATION FORM
Inforrrtation Worksheet
JOB STREET ADDRESS: E 703 -77
CITY/STATE/ZIP: SGb�q�le k.)A- PARCEL NUMBER:
OWNER: %20v PHONE NUMBER: 92-2--7/1-0
MAILING ADDRESS: /
(Street) (City/State) (Zip)
CONTRACTOR: LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT =AMOUNT
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 =
x 25.00 =
GAS WATER HEATER I x 10.00 = /
GAS EQUIPMENT«Op,t 00 BTU(INCLUDES <. x 12.00 =
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
x 1.00 =
BOILER/REFRIG 1-100M BTUx 12.00 =
x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
BOILER/REFRIG 1,0001 1.,750M B7C1......... 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 =
HAT PUM .AII C NDITIONEI 15 3 TANS ; x 25.00 =
HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 =
HEAT PUMP AIR CONDITIONS�+50 TONS : '>>:>:'>> x 60.00 =
VENTILATING FANS x 10.00 =
EV `AP
x 10.00 =.ISA
-
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
x 10.00 =
CLOTHES DRYER x 10.00 =
x 10.00 =
GAS LOG x 10.00 =
MISCELLANEOUS.m.-Ispg(014.00a(N-qt COVERED ELSEWHERE: x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINSTECI GAS APPLIANCI_ 400,(00 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 =
x 15.00 =
SUBTOTAL $
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE =$ 3(, #6e>
SIGNATURE 1/49-7
Spok a County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675