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1992, 12-01 Permit App: 92010526 Mechanical Fixtures
u100, -D Musi' -YUMECHANICAL PERMIT APPLICATION FORM L-\ Information Worksheet JOB STREET ADDRESS: CITY/STATE/ZIP: OWNER: g•;11,1 E2),DS fl c2 -15a c_12 ) ARCEL NUMBER: PHONE NUMBER: :5,We7 -67 Liq MAILING ADDRESS: P, &X (1? 53 1 (Street) Inc; (gity/State) (Zip) CONTRACTOR: fi (71-2 aN,\ 1--/e6chVL 6oENSE NUMBER: PHONE NUMBER: 53 -CO - (47 1 MAILING ADDRESS: 5flivte (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)_, ••••• ••::, • •••::. 4.**Emike4E-44--et:ASKEK GAS WATER HEATER •: GAS EQUIPMENT +100,000 BTU DUCTWORK) k• latk.611.4:9 .4•K‘• c,,,,N„omzwm BOILER/REFRIG 1-100M BTU 7,firektdANZ).'"vrrIni %„'Z' 'TA 4 t, >AMA BOILER/REFRIG 501-1,000M BTU 11:010:11011FOr aa: BOILER/REFRIG +1,750M BTU .C. A :•.• :•-•:•:•:•.•:•••:," • Ave.vt.4..i.:vd HEAT PUMP & AIR CONDITIONER 3-15 TONS LATLIVAERAT 6 Trtievtlitai HEAT PUMP & AIR CONDITIONER 30-50 TONS ZLIMINER41204111101eh...,::::: VENTILATING FANS TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD) "'"15H6t.:Viagt,."..W :::West•MERNMPANSIM,M 4.-JA•giSMASAAkign CLOTHES DRYER GAS LOG MtS(.L1A UNLISTED GAS APPLIANCE <400,000 BTU USED.. APPLiANCE...<46.0,600 BT -U • • •:•:•:. : • • AIR HANDLER <10,000 CFM LER-miiftwmgmimmaft,, NOTE: MINIMUM PERMIT FEE IS $35.00 (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x10,00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x 1.00 x 12.00 = x20.00 = x 25.00 = x35.00 = x 60.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x60.00 = x 10.00 = x 10.00 = x 50.00 = x10.00 = x10.00 = x 10.00 = x 10.00 = x10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = I 1 (9, . SUBTOTAL $ PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675