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1992, 08-17 Permit App: 92006487 Gas Line Air Test �c� alin 1150 L_,LA SSS 9Q - ,9(-\z-1 �o MECHANICAL PERMIT APPLICATION FORM G `Informatt'bn,Worksheet � JOB STREET ADDRESS: I(7 9 ! fJ CITY/STAT IP: . . i / - �,��, .�E'.. PARCEL NUMBER: OWNER: PHONE NUMBER: I r , MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: Heat Transfer Inc . LICENSE NUMBER: Heatti - 1881n PHONE NUMBER: 328-3400 MAILING ADDRESS: N . 1008 Ruby Spokane , WA 99202 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = x 25.00.0 = ......... .. ....... GAS WATER HEATER x 10.00 = 00 A x 12. = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = GAS PIPING (EA OUTLET) x 1.00 = BOILER/REFRIG 1-100M BTU x 12.00 = - x 20.00 = :,: .;_>X11'::.;»�<.�«._<.`.<.:.�:<NCBT �< �> ���< < ' <><<< ><�>�>`<' ><= 6011, Airl� .:: G:. 1��.-5�0:;;:;:.;:_:.�. ..:.:: : :�...........:::.. :-::-;:.:.;;: BOILER/REFRIG 501-1,000M BTU x 25.00 = 1 : EFRiG..1.`0001. 750M.STU. >>`>>>> ::::1>:: .: .39 x 35.00 = 130 L1=f�# : :�. :;:::;:.;F . .:;:::,::: BOILER/REFRIG +1,750M BTU x 60.00 = HEAT PUMP.$AIAONITIONER 0 3:TONS::":°`'`''' x 12.00 = HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 = HEAT PUMP &AIA CONDITIONER 15 30 TONS x 25.00 = ...:.:.......:.......................................................................... .: ................................. HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 = HEAT PUMP AIR CONDITIONER +50 TONS x 60.00 = VENTILATING FANS x 10.00 = EVAPORATIVE COOLERS x 10.00 = TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = TYPE;II HOOD x 10.00 = CLOTHES DRYER x 10.00 = r RA x10.00 = GAS LOG �t�f 10.00 = 'MISGE € 1E.0!).$;.OTcOVERED ELSEWHERE = >?:<v 10.00 = ;1 C) r UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = x 1 0 00 UC,INSTC-n GASAPPI.tAt�CE�4p0, BTU �`.`� ..... . I � O 0 = USED APPUANCE<400,000 BTU x 50.00 = xt = :t�s ::l�.�,�,t:.:.,...:..... imi •� ,�. 199 00 00 .:....... ...... ..h.v.mn...nx.........:4Nin•:i:::Y:-:nv.�:ii:_:::v.�x:::::::::::::::::nom::::::::::::.?:: AIR HANDLER<10,000 CFM x 12.00 = FA......R.........A.......O....L.......R....>.�::::.O4O:& M : . . :€ >»>< ; 1 :gIW : : &SAFETY x 15.00 = SUBTOTAL $ /0 . PLUS: PROCESSING FEE • +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS:TOTAL PERMIT tFEE DUE =$ 1,/6 • SIGNATURE d 4 Td(illi Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675