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1993, 01-21 Permit App: 93000318 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM Information Worksheet I , JOB STREET ADDRESS: / .-- CITY/STATE/ZIP: ..--(101 p() OWNER: ---)241--A4 \i/•/‘ ( J6 C.) MAILING ADDRESS: '-'50 1/0 f (Street) (City/State) (Zip) CONTRACTOR: OU/ LICENSE NUMBER: u &lc -3 3 PARCEL NUMBER: PHONE NUMBER: MAILING ADDRESS:.- /7 0 ci (Street) DESCRIPTION PHONE NUMBER: (City/State) 7 M EC H AN I CAL WORKSHEET/FEE SCHEDULE ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) -••••••••••-••••••••••••••"------------ - • GAS WATER HEATER - ••••••••• _.••••* --•••••• • • GAS EQUIPMENT +100,000 BTU DUC.TWORK).,. ••••••••••••• ••: '• -"" BOILER/REFRIG 1-100M BTU •• • BU „.. , BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG 4-1,750M BTU HEAT PUMP & AIR CONDITIONER 3-15 TONS " HEAT PUMP & AIR CONDJTIONER 30-50 TONS VENTILATING FANS SAA.P.•ii::iii'siMieninirs::•• • • - - • • - • • • • • • ,...,A4-:::::. ,:.0.1:gmEi§iii..sii:Eigaiint,...„ TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD) TYPEI .. - ,,,:ss.,:„.,..::::.::„:„.,:.,:„.3..q.....:*if:iiim-iva.,::,..1....„s.x...slsr.:v:..e..:,,,,..1:::e,,,,,,::.:::::-:,:ia:-::::Iiiiii.,1.,1,•:.:.:1•,.:,;.:it:::::::,,:f::::•smitgisti, ...,....,„•:-,...-•,,,,:::::„::::*4.,:w .„.:„....:„.„:::.„....„.-.....„.„, • „ ...... CLOTHES DRYER GAS LOG ••• ...• UN LISTED GAS APPLIANCE ‹400,000 BTU USED APPLIANCE <400,000 BTU U$D AP LIANGE>4OOOO� BTU• AIR HANDLER <10,000 CFM AIR HANOLER >1OOOO CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE lit (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 x 25.00 = = 1 x 10.00 x 12.00 x 15.00 x 1.00 x 12.00 x 20.00 x 25.00 x 35.00 x 60.00 x12.00 x20.00 x 25.00 x 35.00 x 60.00 x10.00 x10.00 x 50.00 x1000 x10.00 x 10.00 x10.00 x 10.00 x 50.00 x100.00 x 50.00 x100.00 x 12.00 x 15.00 = = = = = = = = = = = = = = = = = = = = = = = = = = = = /Moo 1,00 • SUBTOTAL $ PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE -a0tCt Spokane County Division of Buildings 1,3(1,1 MrnnriaAinv Ariont qnnleana WA C192R11 1FflQ 4R -1R7.5