1993, 08-04 Permit App 93006533 Furnace, Wtr Htr146--2o l 4 F 0143 _
f" *'J ,p6, I I -, Tr, z� MECHANICAL PERMIT APPLICATION FORM
" Information Worksneet
JOB STREET ADDRESS: 7(/ �7 5 • 9 /V,P
CITY/STAT IP2) 4 4'2 ,GCJG . ;,206 PARCEL NUMBER:
OWNER: CP . c---S-647 C CLUL. PHONE NUMBER: A/' ./% '%
MAILING ADDRESS: .JJ 6l.m( Q .
-10533
may}cif1 r (Street) (City/State) (Zip)
CONTRACTOR:�O I. ' - r• E ULt.v21 LICENSE NUMBER: N G e-ri-t tt A 0 172..- D
MAILING ADDRESS:( / `i 41q
(Street)
DESCRIPTION
PHONE NUMBER:
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
>1NOQDSTO E/.1NSi"RT?;
GAS WATER HEATER
IN.CLUD.ES:>
GAS EQUIPMENT +100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
.UOI 1130.1g I 1 Q1 SOOM ; U:'
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG +1,750M BTU
H AT•PUM > <` I.. :ONO$TIQNI±R TANS `
HEAT PUMP & AIR CONDITIONER 3-15 TONS
?;REATPUMP I..F: TON, .
HEAT PUMP & AIR CONDITIONER CONAJTIONER;`1:5.40 30-50 TONS
HHEAT PU: +LP B AJR CO VQITLON R a50: TONS
VENTILATING FANS
�.}w;�:I�ye`...K„A:!1.:7::A7;�;�}�'4••1M..M.blwJkl.N•;::<:.y:;::!'t2:.;{;..;:.;y`;;;;;:>;;ai:.;? �ii%:;,i5;rs:•::
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
RANGE ''
GAS LOG
MIS D EISEWH. RiA
UNLISTED GAS APPLIANCE <400,000 BTU
V NSEI GAS.ANCE>4OO
USED
,TAPPLIANCEPPLJ<400,000 BTU
•
V �7�..1.{ .+S:s�::....R;w,w�t�is>Sw w,.r.w.w:
AIR HANDLER <10,000 CFM
AI: <8A.I.NQI E } 1 000 GEM
•
NOTE MINIMUM PERMIT FEE IS $35.00
SIGNATURE
f?)1.
) 26 Spokane County Division of Buildings
West 1-303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x25.00=
x10.00 =
x 12.00 =
x15.00 =
x 1.00
x 12.00 =
x 20.00 =
x 25.00 =
x35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x25.00 =
x35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x
SUBTOTAL
$ ,36_0p
+ $ 25.00
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
FEE DUE
=$ 6/0°