1992, 01-06 Permit App: 92000083 Mechanical FixturesMECHANICOL.PtRMIT APPLICATION FORM
Information Worksheet
-JOB-STREET ADDRESS: .s /6,/6 uicrettw.
'CITY/STATE/ZIP:prka-/W 164992/
OWNER:?2) 0 ictits4_
MAILING ADDRESS:5 //0/ Oin Pci
(Street)
CONTRACTOR: AIR DESIGN, INC.
PARCEL NUMBER:
3
PHONE NUMBER: ggo - /003
Okbruu 1,04 9L 2 (i
(City/State) (Zip)
LICENSE NUMBER: AIRDEI*161JW
PHONE NUMBER: 487-4328
MAILING ADDRESS: E 1815 FRANCIS SPOKANE WA 99207
(Street)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
DUCTWORK SYSTEM
• WOODSTOVE/INSERT
• GASWATER HEATER
HEATING EQUIPMENT.<10000Q BTU
HEATING EQUIPMENT +100,000 BTU:
GAS PIPING (EA OUTLET).
REFRIG 17-100M BTU '(NOT A/C pR.HEATTUMP)
.RE'FRIG 101-500M BTU
REFRIG 501.,-1.,000M BTU
1,001-1,750M,BTU
'REFRIG +1,750M BTU •
PUMP'& AIR'CONDITIONER 0-3 TONS.
,HEAT PUMP,& AIR CONDITIONER TONS
1-0T PUMP & AIR CONDITIONER'15-30'TONS
:HEAT PUMP • & AIR CONDITIONER .30750 TONS
'HEAT PUMP & AIR CONDITIONER 4-50. TONS
VENTILATING FANS •
EVAPORATIVE COOLERS
.TYPE I HOOD (PER 12' OR .12' PTN.. OF' HOOD)
•TYPE la HOOD
CLOTHES DRYER
RANGE
GAS LOG.
'MISCELLANEOUS (NOT COVERED ELSEWHERE)_ _
• UNLISTED GAS APPLIANCE <400,000 BTU
UNLISTED GAS APPLIANCE >400,000 BTU_
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIRHANDLER <10,000 CFM
. AIR HANDLER >10,000 CFM
I
•x$10.00
x 25.00 =I
=
x 10.00 =
x 12.00 = /4,00
X 15.00 =,
x 1.00
X 12.00-
x 20.00 =
x 25.00 -
•x 35.00 =
x 60.00 =
x 12.0C =
x 20.00 =
x 25.00,,
x 35.00 =
x 60.00 =
x 10.00 =
AMOUNT
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 =
x100.00 =
x 12.00 =
x 15.00,"
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
$ /3.Y
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= s 60
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 9-9260 (50,9)'45,63675