1992, 12-16 Permit App 92011037 Wtr HtrMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
Date: if.;L Q�
JOB STREET ADDRESS:
CITY/STATE/ZIP: 1 D1•C-4, Q (AJ
OWNER: PC -eh CmfD�.
PARCEL NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State)
CONTRACTOR: Ripley's Plumbing, Inc. LICENSE NUMBER: RIPLEPI107B6
PHONE NUMBER: 509-535-1919
33;,7
MAILING ADDRESS:
4104 E Pratt
Spokane, WA
(Zip)
99202
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
...........
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS:PIPING (EA OUTLET}... . :v ..h
BOILER/REFRIG 1-100M BTU
:1�{j:Sh:::{.hi'i' ii r:'.
:}}''.%}^ii'-}:h}'•'4}i'n$};:i}l?jYr::Yr :4::.>
•'.1.7E :Vi'/.: r.".�7tii7.1Y1:'•'�7-.`:i1:ry:,.}:;?:::::`:.�..f-:.-::.t-.�:..}.:..}::: v:.... ;.{,.{r.'
BOILER/REFRIG 501-1,000M BTU •
:;BOIL R1 3E RIG _7;s000 t 1,7 OM BTU
BOILER/REFRIG +1,7'50M BTU
H EAT PUMP; & A:IR C.OND1T).ON ER :0:-3 TANS;::;:;';;
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT:PUMP&`AI.R C0ND1TIONER;:15-3.0`TONS.
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEA P JIULP R AIR COf DITI:ONER +:0`TONS > <<
VENTILATING FANS
.APORATIVE COOLERS:;_ ,>
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYF.
E11 CLOTHES DR`fER.......:....................................:.......:.....
GAS LOG
•
UNLISTED GAS APPLIANCE <400,000 BTU
ry
.....:.,.:. .M,.:.{„r.,,:. rn..,.•.bs::::w.,�.�':,,�}x?C��W
USED APPLIANCE .<400,000 BTU
-y-}•?.C:{r::�r,<;�r{V.{..�r.}rG•�,. {.,;r y}W4v�},�p,.u::;jr{,.,y:;•;�.n•«.i}:y..:.{�;»:.:.i'•`::;::�:::E.}f:;f•:n_:f.::
x,:,;,;;.• } � ti,w:r..,.awc;hr2a�.:w.t, }..a..a7. :Jx.,,:�'.�S'aw,c.::•':,Gw«nkL�/{i�.S`a4}o-�• �>M:{:ww:
AIR HANDLER <-10,000 CFM
:.,,y.:yr.•:{:-y,w?.: �y.•.r :: r/>3r',F�.wyyyhyy.:, r ry r{., may.•..• .r� .:..>:}. x�,'.w:raom}..:. µme,
R:.:. AEI. Ei...:
NOTE MINIMUM PERMIT
SIGNATURE
(ZIP)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
x12.00 =
x 15.00
x 1.00 =
x12.00=
x20.00=.
x25.00 =..
x 35.00 =
x 60.00 ='
x 12.00 =
x20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
.
//0,0-0
t
icOD
'.
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x50.00=.
x100.00 =
x 12.00 =
x15.00 =
SUBTOTAL
$ if JO.
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ 3(0,0°
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675