1992, 11-10 Permit App: 92009940 Mechanical FixturesJOB STREET ADDRESS:
MECHANICAL, PERMIT APPUCAT1ON FORM r& /
Information Worksheet �'
4/. /Jol (� ' I- �K D
CITY/STATE/ZIP:. r5ka AWA • �1� 1 oZ PARCEL NUMBER: `'Y > /e 1 . 4"I
OWNER: UC) \\ ri1 + %P\J PHONE NUMBER: (c l - b9
MAILING ADDRESS:
(Street) (City/State)
CONTRACTOR: Heat Transfer Inc. LICENSE NUMBER: H e a t t i -18 81 n
PHONE NUMBER: 328-3400
MAILING ADDRESS: N. 1008 Ruby Spokane, WA 99202
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
GAS QIMPMF tOt} t 00 8T` 1(INC UDES >
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS;:Q{PING;:EA
BOILER/REFRIG 1-100M BTU
.......:......................................................
BOILER/REFRIG 501-1,000M BTU
;B01LI= .-.1. 0(01: 0(* 1750;::.::..:;::
BOILER/REFRIG +1,750M BTU
HEAT>PUMP;&`AIR CONDITIONER:0-3_TONS< << :>
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT:_PUMP:;&AIR:<COND!TIONER1.5 30;TONS;'_
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT:.PUMP:B� AIRCONDtTIONER'+50TONS':<',
VENTILATING FANS
Ey RATi.yg,COOLERS
....................................... .
TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
:...,.............::::.
RANGE:::::;;
...:.:..:..::..::......
GAS LOG
UNLISTED GAS APPLIANCE <400,000 BTU
LI
USED APPUANCE <400,000 BTU
I�S.E1AlVGE ?Ot>o�I:BTi7 t<`<<
AIR HANDLER <10,000 CFM
•
NOTE: MINIMUM PERMIT FEE IS $35.00
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x10.00 =
x12.00 =
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 =
x25.00 =
x 35.00 =
x60.00 =
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 =
x15.00 =
/0. 00;
c� r1
o2 •_)
SUBTOTAL
$ (21/00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
- $ �q,O
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675