Loading...
1993, 02-05 Permit App: 93000634 ACJOB STREET ADDRESS: CITY/STAT ZIP' Q- Q , qq�/lc PARCEL NUMBER: 4/.6).3--.3 , /96 9 OWNER: -Jt 6 of PHONE NUMBER: ?.,>26 0,-/ MAILING ADDRESS: 0---')/12- �,/ /' (Street), (City/State) (Zip) CONTRACTOR:/ /l': ? 0--t-t-4; Q/ (}- , LICENSE NUMBER: /2(J/(P 74- e- /VJ 7 9:,2,) - .,99 APPLICATION FORM 3- � 3c( i (-NS MECHANICAL PERMIT APPLICATION FORM Information Worksheet 7 f MAILING ADDRESS: `�' �3 �/ 9 PHONE NUMBER: DESCRIPTION (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) >.ADSO: GAS WATER HEATER :G .:EQU1PM NT 00 000 BTU::(INGLUpr*s:: GAS EQUIPMENT +100,000 BTU DUCTWORK) <GAS.... PIM. P.. GEA>Q `..: ` > « BOILER/REFRIG 1-100M BTU OILER/REF :. 1 .G 1.01.00M BOILER/REFRIG 501-1,000M BTU :8Q1.LERLR. FRI+ 1 0001 1760M>UT.u.< >>' > >>;. BOILER/REFRIG +1,750M BTU H T PUMP &A R CONDITIONER 0- .TON HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT Pt1:M.... CONQrTIQN 1 1 + O'CQN HEAT PUMP & AIR CONDITIONER 30-50 TONS JR:CONDITIQNER 50;TOMS:>>; VENTILATING FANS In C9 TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) CLOTHES DRYER GASLOG::.....:...........,.v....,.....v..............................................:................... MISE AMEO S .(NOT COVERED EI;SEWH.ER UNLISTED GAS APPLIANCE <400,000 BTU U.MSTED GAS APPLIANCE X100`000 BTU.::»>:>» USED APPLIANCE <400,000 BTU AIR HANDLER <10,000 CFM AIRHANQIER 1+.o.:..0.,CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATUR (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x1.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x60.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 - x 60.00 = x 10.00 = x10.00 = 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 = / /,. 6 0 SUBTOTAL $ /a 1)(5 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =$ J"2'06) Spokane County Division of Buildings tA/ncf ignq rnnrl.u•• .es \AIA AA')CA /CAA\ ACC rfC-7c