1992, 12-14 Permit App 92010907 Wtr HtrJOB STREET ADDRESS:
CITY/STATE/ZIP:
OWNER:
MECHANICAL PERMIT APPLICATION FORM
Information Work heat •
S �31
PARCEL NUMBER:
2 - /0?0 7
se
CU PHONE NUMBER: mil. 11 ea'Qt -S9
MAILING ADDRESS:
CC-cZ Z-6- c 41
(Street) .. (City/State) (Zip)
CONTRACTOR: t9-ri-_.1 a-- * L 1, LICENSE NUMBER: - -t--- L 16 6'Z-
PHONE NUMBER:
MAILING ADDRESS:`
(Street)
(City/State) (Zip)
MECHANICAL WORRSti z1/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIPING (5 OR MORE. EACH:)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS _
HEAT PUMP & AIR CONDITIONER 15-30 TONS _
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR CONDITIONER +50 TONS _
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR '12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE)
UNLISTED GAS APPLIANCE <400,000 BTU_
UNLISTED GAS APPLIANCE >400,000 BTU_
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM
2
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 4.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
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 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
= AMOUNT
Lbw
Z90
SUBTOTAL I $
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
NOTE: MINIMUM PE T FEE IS $35.00 FEE DUE
SIGNATURE/Q�a1
Spokane County Department of Building' and Safety
+ $ .25.00
= $