HomeMy WebLinkAbout1993, 05-17 Permit App 93003618 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
MAILING ADDRESS: ZAA..cil IL 1•.. �. S
Liat
(Street)
JOB STREET ADDRESS:
CITY/STATE/ZIP:
OWNER:
MAILING ADDRESS:
PARCEL NUMBER: 4'(5) 7 ,. I V )5
(Street)
PHONE NUMBER: l Z� `1( / 7
L/
.wnr 4 c Ze-4
(Ciy/State) (Zip)
CONTRACTOR: P. I%2.-rb ►� S eZ &-L.LLLICENSE NUMBER: - -Sr 2 -n -15, 1, LP ciSZ
PHONE NUMBER: ZZ - Soc.
c
SPQ I - 000I 'A->41
(Cit /State) (Zip)
MECHANICAL
DESCRIPTION
WORKSHEET/FEE SCHEDULE
NUMBER X EACH
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 PI?ING (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 &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER 0-3 TONS
AIR CONDITIONER 3-15 TONS _
AIR CONDITIONER 15-30 TONS _
AIR CONDITIONER 30-50 TONS
AIR CONDITIONER +50 TONS
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
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
0--
x$
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 =
SUBTOTAL
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
FEE DUE
= AMOUNT
+ $ 25.00
= $ to -
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675