1993, 04-16 Permit App: 93002574 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM cA3,,,.ZS.-i
(f
Information Worksheet
JOB STREET ADDRESS: `7` n s S. t3o boAJ S rJ 15017-
CITY/STATE/ZIP: j/A . 49?'& PARCEL NUMBER:
OWNER: A is eu kw 1,) iti PHONE NUMBER: Gi-r' -fiOO
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: Heat Transfer Inc. LICENSENUMBER: Heatti-1881n
PHONE NUMBER: 482-2000
MAILING ADDRESS: N. 3003 Crestline Spokane, WA 99207
(Street) (City/State)
,r
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER .......................................................
GASEQU1PM '<t ;OO O Z.-. . Nc
GAS EQUIPMENT +100,000 BTU DUCTWORK)
EiPING (EA OUTLET):..
BGILER/REFRIG 1-100M BTU
•BOILER/REFRIG 501-1,000M BTU
'BO LEf ?ER iGI' 1000` '= : fi50M :11,
BOILER/REFRIG +1,750M BTU
HEAT`PtJMP
HEAT PUMP & AIR CONDITIONER 3-15 TONS
H EAT:.PU M.P;&A:I.R:<:CONDI:TIONER'1:5.-3.0TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT<P .MP`' AIR.CONDITIONER'"+50 TONS. =`
............................:.......:.............................................................................
VENTILATING FANS
EVAPORATIVE.C.00LERS
...........................................................................................................
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TY P E'lt:: N
............ .. ..............................................................................
CLOTHES DRYER
GAS LOG
UNLISTED GAS APPLIANCE <400,000 BTU
:l1 I i iV S't' ED'AQA S A l
USED APPLIANCE <400,000 BTU
tSE?A.. PI~tANC t::;BT
AIR HANDLER <10,000 CFM
:O0Q TU'
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(Zp)
NUMBER
OF UNITS
X EACH
, UNIT .
= AMOUNT
x 10.00 =
:::..
x 25.00 =
r
x10.00 =
. /Q,nod -
x12.00 =
x 15.00 =
x 1.00 =
v.?, Uc_)
•
x 12.00 =
x 20.00 =
x 25.00 =
x35.00 =
x 60.00 =
x12.00 =
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 =
rA
in) ion
x 10.00 =
x10.00 =
/, DO
'1
x 10.00 =
x50.00 =
x100.00 =
x 50.00 = , •- -
x100.00 =
•
x12.00 =
-
x15.00 =
SUBTOTAL
$ '34/.06,
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ 5-9,00
Spokane County Division of Buildings
West 1026 Broadway Avenue Spokane, WA 99260 (509) 456-3675