1991, 08-13 Permit App: 91004988 Mechanical FixturesX3 - 3 , 7
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
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JOB STREET ADDRESS: no 0 o
CITY/STATE/ZIP: , /4/A , 99)d
OWNER: ' I fty
MAILING ADDRESS:______._. _ 5.4 Al
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CONTRACTOR: E. 102 NORA
SPOKANE. WA 96207
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MAtuNG ADDRESS:_._.___WAYNE81i25eN,i
PARCEL NUMBER:
PHONE NUMBER:
(City/State) (Zip)
LICENSE NUMBER:
PHONE NUMBER:
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK, (SEPARATE SYSTEMS)
WOODSTOVE/1NSEPT
GAS WATER HEATER
GAS EQUIPMENT <100,000 £T4 i ;INCLUDES
GAS EQUIPMENT +100.000 BT) DUCTt C,=?K
GAS PIPING (EA OUTLET)
BOIL.ERiREFRIG 1..130M BTU
BOILEWf EFRtt V)! -500M 810
BOILER/REFRIG 5: - I ,000M BTU
BOJLER'IIEF i.IG 1,001--1,750M BTU
BOILER/REFR(G 4 i .750M BTU
HEAD' PUMP & AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-1b TONS
HEAT PUMF & AIR CONDITIONER 1540 TONS
HEAT PUMP & AIR :OF C;}TIONER 30-50 TONS
.HAAT PUMi 8 AtR3 C01,4; ; TIQNER +50 TONS
VENTILATING FANS
.EVAPORATIVE COOLERS <,
TYPE I HOOD (PER 12' OR 12 PIN. CF HOOD)
TYPE ft HCADD
CLOTHES DRYER
RANGE
GAS LOG
MISG&tANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
U .UNST 7 SAS At'PLiANCE >400,000 BTU
USED APPLIANCE <400,000 BTU
u . 1,.1M!ia ]4%.000 i ru
AIR HANDLEFI <10,000 CFM
101:41fiAt45LEF#>300
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE 91'114%-t_
(P)
NUMBER
• OF UNITS
X EACH
UNIT
= AMOUNT
U 11 11 11
888
unci
X XXX
{
I
11i
I
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 3 F j:'"
Spokane County Division of Buildings
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