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1993, 01-06 Permit App: 93000050 Mechanical Fixtures-3511 '010ett , .. MECHANICAL PERMIT APPLICATION FORM 9 3- c 5o Information Worksheet JOB STREET ADDRESS: / 3 /0 /1 8060 i4a ,-) ,4?‘"/ / CITY/STATE/ZIP:3'pr) .61412, /j4.-. .W -17/,Q PARCEL NUMBER: OWNER: 7r9/12 5/th/f.,,,, IL PHONE NUMBER: 9f' -/d4 ? MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: Heat Transfer Inc. LICENSE NUMBER: Heatti-1881n PHONE NUMBER: 3 2 8-34 0 0 MAILING ADDRESS: N. 1008 Ruby Spokane, WA 9 9 2 0 2 (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION EciTCRI /D:.UCTW. ORK(SEpARATE SYSTEMS) sT BTUGAS WATER HEATER DUCTWORK) GAS. BOILER/REFFila 1-100M BTUBO1ERE• - " BOILER/REFRIG 501-1,000M BTU t.„ . . BOILERIREFRIG +1,iiom BTU HEAT.PUMP& A!R CONDITIONER 0-3 TONSHEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMP& AIR CONDITIONER +50 TONS VENTILATING FANS EVAPORATIVECOOLERS TYPE I HOOD (PER 12' OR 12PTN. OF HOOD CLOTHES DRYER GAS LOG Mit4:-1340.E0OSNOMVEAEtirtEgEWREMOVO UNUSTED GAS APPLIANCE <400,000 BTU USED APPLIANCE <400,000 BTU • AIR HANDLER <10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00 (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x10,00 = x 25.00 = x10.00 = / /0,00 i 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 = x10.00 = x10.00 = x 50.00 = x10.00 = x10.00 = x10.00 = x10.00 = x10.00 = x 50.00 = x100.00 = x 50.00 .7-: x100.00 = x 12.00 = x 15.00 = =19. G)c/ SUBTOTAL PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = '9,o) SIGNATUREY2&rfed:4b,th Spokane County Division of Buildings West Broadway Avenue Spokane, WA 99260 (509) 456-3675 10.2