1991, 11-14 Permit App: 91007859 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: 5. ' 3 )C,:q\1.S1+-
CITY/STATE/ZIP: 5R!!6G AN�/ WA- PARCEL NUMBER:
OWNER: . M G (PAT} -E- (Thcrryn e.) PHONE NUMBER:
MAILING ADDRESS: (ine,)
v8 - ,Ven
(Street) (City/State) (Zip)
CONTRACTOR: R & R HEATING & A/C, INC. LICENSE NUMBER: RRHEAA*106BW
MAILING ADDRESS:
E. 1723 Francis
PHONE NUMBER: 484-1405
Spokane
WA 99207
(Street)
MECHANICAL WORK
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
•
GAS WATER HEATER
GAS Q;PM n
GAS EQUIPMENT +100,000 BTU DUCTWORK)
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BOILER/REFRIG_:1-100M BTU
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BOILER/REFRIG.501-1,000M BTU
BOILER/REFRIGM#1750M""BTU '
HEAT=PUMP4Ai )CONDITIONER 3-.15.TONS.
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HEAT1:PUMP& AIRCONDITIONER 30=50: TONS
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VENTILATING.FANS.'`r .--
Vii csc GV'�5 aws�
TYPE I HOOD�(PERa12'. OR 12' PA..
TN. OF HOOD)
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CLOTHES DRYER.,"
ter: v .
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GAS LOG
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UNLISTED GAS APPLIANCE <400,000 BTU
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n.
USED APPLIANCE <400,000 BTU
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AIR HANDLER <10,000 CFM
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NOTE: MINIMUM PERMIT FEE IS $35.00
(City/State)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
l
x 12.00 =
(a.CrD
x15.00 =
l
x 1.00 =
1 O
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00
x 60.00 _
x 12.00;=;.`
x 20.00-=y
!x25.00' .
x 35.001='``v
x60.00=
x 10.00.=,
x10.00 =
x 50.00=
x10.00 =
x10.00"=
x10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
, ..
x100.00 =
x12.00 =
x 15.00 =
SUBTOTAL
$ 13.cc
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 5.00
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675