1995, 11-30 Permit App 95009931 Gas LogMECHANICAL PERMIT APPLICATION
BOILER/REFRIGERATION
BOILER/REFRIGERATION
BOILER/REFRIGERATION
GAS LOG, GAS INSERT, AND/OR GAS FIREPLA
RANGE
DRYER
FUEL BURNING WATER HEATER
MISCELLANEOUS FUEL BURNING APPLIANCE
GAS PIPING (ea. outlet)
DUCT SYSTEMS
VENTILATING FANS
AIR HANDLER (DOES NOT include duct systems)
AIR HANDLER (DOES NOT include duct systems)
EVAPORATIVE COOLERS
TYPE I HOOD
TYPE II HOOD
HEAT PUMP/AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
LPG STORAGE TANK
WOOD OR PELLET STOVE/INSERT
NOTE: MINI
SIGNA
OWNER:
MAILING ADDRESS:
cc (street)
CONTRACTOR: , r . ( rti- $ 7`G- �Jc. , S h c p
MAILING ADDRESS: t Z-/(%
DESCRIPTION OF WORK
FUEL BURNING APPLIANCE
UNLISTED APPLIANCE (ADDITIONAL CHARG
UNLISTED APPLIANCE (ADDITIONAL CHARG
USED APPLIANCE (Must meet WSEC's min. AFU
USED APPLIANCE (Must meet WSEC's min. AFU,
BOILER/REFRIGERATION
BOILER/REFRIGERATION
1-, - gg31
CONTACT C/ " 66, s73
37 (atyTstate) (nP)
LICENSE: tea{. L FO C7 e / 73 0 w
PHONE: ion -.PS //
(zip)
(cttylstate)
OF UNITS
= or <100,000
> 100,000
= or <400.000
>400.000
= or <400,000
>400.000
1-100M BTU
101-5OOM BTU
501-1,000M $iu
1,001-1,750M BTU
+ 1.750M BTU
= or < 10,000 CFM
>10.000 CFM
0-5 TONS
6-15 TONS
16-30 TONS
31-50 TONS
+50 TONS
M PERMITE IS $35.00
-
1. J /CUNNIIT
a
.
.
a
a
•
a
a
a
a
a
a
2
a
a
a�
$12
S15
$50
$100'
S50
$100
$12
S20
$25
$35
60
$10
$10
$10
$10
$10
S1
S10
$10
S12
$15
S10
S50
$10
$12
S20
$25
$35
$60
$10
$25
saw
$
• a
• s
-r
.
• $
s
->3
. 4
•a
• a
• .
e
-
•
Subtotal
PLUS: PROCESSING FEE
TOTAL PERMIT FEE DUE
777,
Spokane County Department of Building & Planning SPOMar'
1026 W. Broadway Spokane, WA 99260
Tel. No. (509) 456-3675 • Fax No. (509) 324-3198 $ TDD No. (509) 324-3166
Spokane County does not discriminate on the basis of disability in the admisioa to, or treatment or employment in, its programa a act
AMOUNT
/0
Rte037:—
MIN
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