1993, 05-27 Permit App: 93004027 Water Heater, Piping C)4\3 9 0 -L1
; , MECHANICAL PERMIT APPLICATION FORM
L ' .: Inf/ormation Worksheet -1 (4 c
JOB STREET ADDRESS: t 5 7" /c
CITY/STATE/ZIP: oS'/Q7e%/vc PARCEL NUMBER:
OWNER: D2 4-z• S' Z/�� y .....----g,5.....----g,5---PHONE NUMBER: . ' .0 /...5.5
MAILING ADDRESS: L. ://.0
(Street) (City/State) (Zip)
CONTRACTOR: AIRE VALLEY HEATING LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS: e : •e l s ' •
(Street) - (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT =AMOUNT
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) X 10.00 =
8tVON ?+pvE/INSERT X 25.00 =
GAS WATER HEATER / x 10.00 = /®
GAS EQUIPMENT i00,000 BTU(INCLUDES x 12.00 =
GAS EQUIPMENT+100,000 BTU DUCTWORK) , x 15.00 =
GAS PIPING;(ocQUTL : / x 1.00 = 7
BOILER/REFRIG 1-100M BTU x 12.00 =
::::>:iiii :»::>::<:>::»>:<::<:;:>:>:<:;•}<::;;;;;:.;:.:;:;::;:>:;:>:::>:: x 20.00 ,----
BOILER/REFRIG
a�OiL�F�l�ily�plGr�U1�.5nUIVl i�t�l... >�>><: >>:<• ...:.....>:<•:•:<:>::<::::;
BOILER/REFRIG 501-1,000M BTU x 25.00 = •
BOILER/REFRIG '1,000). 1,750M$TU : x 35.00 =
BOILER/REFRIG +1,750M BTU x 60.00 =
=
.NEAP'pUMp:�Aid.gONDITI+�NE�t�-o.TOfJS: `�<>`> ' ''`..:
x12.00
HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 = •
• :NE=AT#0..m: Ra CgNDITIONE i st.41.1 TONS x 25.00
HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00
HEAT,.pUMp. II giNpl lioN41 g'itpV,S. <> ><:>:....' x 60.00
VENTILATING FANS x 10.00 =
: VAPORATIVE CCS LE... :> :....::...
x 10.00 =
TYPE I HOOD(PER 12' OR 12' PTN. OF HOOD) x 50.00 =
{n:?:»:.}::^ik}:i•}::}:;: :r:+:;:;i::>ii;S:;Y.+.}}}}}w.:{w.r;n}>:•>::;yy..•.:}i:yC;;::;:i'iii?::.
rYPga fiRO II: >< < $ > ><`><,.:...:... . i .;;JN:::, ::..... x 10.00 =
CLOTHES DRYER x 10.00 =
x
10.00
• .
GAS LOG x 10.00 =
MISCELLANEOUS COVERED ELSEWHE E ; x 10.00
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINSTED.GAS APPLIANCE>400,00oiTU : h x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
USED APPLIANCE�400,Q00 BTU
x100.00=
HANDLER F x 12.00 =
AIR <10,000 CFM
Alp HANDLER�1f1000 CSM ;. ,,
x 15.00
SUBTOTAL $ //00
PLUS: PROCESSING FEE +$ 25.00
r
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE =$ 3e•OU
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
I