1992, 11-23 Permit App: 92010316 Mechanical FixturesMECHANICAL PEFIMIT APPLICATION FORM
/ Q Ih ormation Worksheet
JOB STREET ADDRESS: /2 / A/ ,&,t.cJ yflO Y1
CITY/STATWIP: 15/(b Ai•e t4J4. 9921Z- PARCEL NUMBER:
OWNER: rt;' T V Y\ U'31 PHONE NUMBER: �22'
MAILING ADDRESS: /4'2.1 Al 13atowtctn( iIzt/tAn E) WJ4' 9 Z I Z
(Street) (City/State) (Zip)
CONTRACTOR: 11 i4i * O PIw Li 141 C- LICENSE NUMBER: IAN T E P1. r s8 Cd r
/ / PHONE NUMBER: SOQ - - S00 0
MAILING ADDRESS: E !/8'02. ma_KS } I dc3/ at -a sy, L¢J f'245
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
:..:..U:t:::,.ME:.;•:T 100,00O8T.0 INCLV
GAS EQUIPMENT +100,000 BTU DUCTWORK)
•
BOILER/REFRIG 1-100M BTU
B ::. I . :.1; l= ::R G 1tyl-5.00M 17 .11.
BOILER/REFRIG 501-1,000M BTU
�QILBPI.'''. G 1: ff( 01-1 750M T
BOILER/REFRIG +1,750M BTU
H AT PUMP & AI t Nt .l'CI± N :` ONS:
HEAT PUMP 8t AIR CONDITIONER 3-15 TONS
::HAAT PUMI AIR ONDITION51 :15w TONS >
•
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HSAT PUMP'::::&:;AIP CONDI1IONER 50 TONS> ><
VENTILATING FANS
$:;I;';Tt•'::•i:ii::;:i}i'rJ ;i:: i::;:;:,;':•';:'jf::>i'r;;{i}:iviii
TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD)
II:F
CLOTHES DRYER
GAS LOG:::::> :.........................
MISCELLANEOUS NO`' C,OV f_U ELSEWNEF 1=
UNLISTED GAS APPLIANCE <400,000 BTU
USED APPLIANCE <400,000 BTU
;l1SF[�:>Apf�L
AIR HANDLER <10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
/
%O,(1°
x 12.00 =
x 15.00 =
x 1.00 _
x 12.00 =
x 20.00 =
x 25.00 =
x35.00 =
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 =
°o
SUBTOTAL
$ //4 OC
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE=$36.00
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675