1993, 05-04 Permit App 93003174 Wtr Htr, Htg EquipDESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS EQUIPMENT <1000,000 BTU (INCLUDES
GAS EQUIPMENT +1000,000 BTU DUCTWORK)
GAS PIPING -(EA OUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 101-500M BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,001-1,750M BTU
BOILER/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
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
topte, '„ LSI1-1LCI IANICAL mama APPLICATION FORM O '3 - 3 L ki
�xctS-- Information Worksheet
JOB STREET ADDRESS: 4/(1)41 K3U7/16/..A 03b
bO/ 990?r
Pot,0
CITY/STATE/ZIP:
OWNER: 0
MAILING ADDR SS:
PARCEL NUMBER:
PHONE NUMBER: 9cP4" 35 C9
(Street)
CONTRACTOR: MARTIN SHEET METAL inc.
(City/State) (Zip)
LICENSE NUMBER: MARTISM170KW
PHONE NUMBER: 924-8088
MAILING ADDRESS: BLDG. #103 SPOKANE INDUSTRIAL PARK SPOKANE, WASHINGTON 99216
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
1
x$10.00 =
x 25.00
x 10.00 =
x 12.00 =
x 15.00 =
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
0.00
/;Y,eieJ
SUBTOTAL
$31p,-
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
FEE DUE
+ $ 25.00
Spokane County Department of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675