1993, 07-02 Permit App 93005443 Wtr Htr, VoidMECHAN!CAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS.
CITY/STATE/ZIP:_S
OWNER: ke/r- -,
MAILING ADDRESS:
CONTRACTOR:_
(Streety
S
MAILING ADDRESS: Po ACK
(Street)
DESCRIPTION
C PARCEL NUMBER:
PHONE NUMBER: pzy� - � ?
(City/State)
LICENSE NUMBER:
PHONE NUM ER / 7
/ Y?VfZ2e U f 27S �S -051
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS EQUIPMENT <100,000 BTU (INCLUDES'
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 101-500M BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,0001-1,750M BTU
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0-,3TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER y5:3O: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 1I HOOC3 y
CLOTHES DRYER
RANGE
:s&5 LOG
likaSCELLANEOUS (NOT COVERED ELSEWHERE
..04LiMtU GAS APPUANCE <400,000 BTU
L W* 1 F1) GAS APPUANCE >400,000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400.000 BTU
P ANDLER <10.000 CFiut
AIR HANDLER >10,000 CFI!
NO1 E MINIMUM PERMIT FEE IS $35.00
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
/
x10.00 =
/0cc
x12.00 =
x 15.03 =
x 1.00 =
p°
x 12.00 =
x 20.00 =
x 25.00 =
x35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x50.00 =
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 -
Ix12.00=
x 15.00 I.
SUBTOTAL
$ /f
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_ $ .06
Spokane County Division of Buildings
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