1992, 08-17 Permit App: 92006514 Mechanical Fixtures.2 MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
L JOB STREET ADDRESS: AD /1 ,G / / a.
CITY/STATE//ZIIP: t7 e GU9 t' 9ga/c PARCEL NUMBER:
OWNER: Echo in C SfRet h PHONE NUMBER: 99,'/ g?
MAILING ADDRESS: At 026V/ //C_. A. h,
c -a sic(
515
/ / (Street)
CONTRACTOR: /`hf2/ e OA, n e r►
ChQ'7 ?i/71 017 /41/"'"?` C e- PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
(City/State)
99.2i
(Zip)
LICENSE NUMBER:
T'O SQ
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
GAS Q IPli!>=NT' 100 000 TU (INCLUIDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
BQILPRlRPFR1G
BOILER/REFRIG 501-1,000M BTU
BAILER/REFRIG:> :000M::S7t1;'::::>
BOILER/REFRIG +1,750M BTU
HSAT UMC &>AIC .>C N flONER:;0.=3::TONS >
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HeAT'PUMP &'AIR'CONDITION R 15_-30 TONS`
HEAT PUMP & AIR CONDITIONER 30-50 TONS
..::::::...::::::::........:........... .......:.....:............ ........................ ......
HPAT PUMP>&<AIR ONIDITI:O.NER:+50;TONS
VENTILATING FANS
APORATIWE C-00LRF
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE
CLOTHES DRYER
GAS LOG
MISCELLANEOUS (NOT;COVERRED EL SEWHoi:l
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTEI GAS APPLIANCE >400 000.BTU<<
USED APPLIANCE <400,000 BTU
USED;APP:LI►NCE,00r000"BTU:><:>::::<>><>>< <>>
AIR HANDLER <10,000 CFM
NOTE: MINIMUM PERMIT
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
Y 10.00 =
x 25.00 =
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 =
x 12.00 =
x 20.00 =
x25.00 =
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 =
/42.00
1.00
x100.00 =
x 12.00 =
x 15.00 =
SUBTOTAL
$ /3,00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675