1993, 05-21 Permit App: 93003820 Mechanical Fixtures I
����ESZMECHANICAL PERMIT APPLICATION FORM
Information Worksheet 5 „3,-
JOB
.JOB STREET ADDRESS: East 11517 - 11th
CITY/STATE/ZIP: Spokane WA 99206 PARCEL NUMBER:
Allen Gardner 509-922-1390
OWNER: PHONE NUMBER:
MAILING ADDRESS:• East 11517 - 11th Spokane, WA 99206
(Street) (City/State) (Zip)
CONTRACTOR: Steinmetz Heating & A/C LICENSE NUMBER: STEINHA147KF
PHONE NUMBER: 509-922-2034
MAILING ADDRESS: North 2114 PInes Ste #3 Spokane WA 99206
(Street) (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 = I O•Ocj
HEATING EQUIPMENT <100,000 BTU x 12.00 = 12.00
HEATING EQUIPMENT +100,000 BTU x 15.00 =
GAS PIPING (EA OUTLET) z„ x 1.00 = 2.op
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 & AIRCONDITIONER 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 $ 24.L73.
PLUS : PROCESSING FEE + $ 25. 00
EQUALS : TOTAL PERMIT
NOTE: NIMUM • RMIT FEE IS $35 . 00 FEE DUE = $ • )
1
I S okane County Department of Buildin and Safety
st Broadway Avenue Spokane, WA 9260 (509) 456-3675