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1993, 05-24 Permit App: 93003899 Mechanical Fixtures
MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: 40) A/310 3 - CITY/STATE/ZIP: .S cu4 PARCEL NUMBER: OWNER: PHONE NUMBER: MAILING ADDRESS: 5.,,,A.-4t.a_ (Street) (City/State) CONTRACTOR: /e...ehee-41r -e&A,4 LICENSE NUMBER: PHONE NUMBER: MAILING ADDRESS: g2 - (Zip) (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/Du CTw wato GAS WATER HEATER GAS EQUIPMENT +100,000 BTU BOILEFil DUCTWORK) GAS REFRIG . • 1-100M BTU IG BOILER/REFRIG 101-500M BTU .11"- Bo REF 0M 1'EX.1?00:4#A!G. +1 ,--igitBTU BOILERIREFRIG 1:41$0m,BTU ). BOILERIREFR HE , CONDITIONER ..• AIR HEA CONDmONER 15-30 TONS AT PUMP & AIR 30-50 TONS -NO HEAT PUMP & AIR CONDITIONER +50 TONS VENTILATING EVAPORATIV COOLERS TYPE 1 H000 (PER 12' OR 12' PTN. OF HOOD) „ . „.. CLOTHES DRYER ' • ... GAS LOG UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED • • " USED APPLIANCE <400,000 BTU AIR HANDLER <10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE (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 = x12.00 = x 20.00 = x 25.60 = x 35.00 = x 60.00 = x 12,00 = x 20.00 = x 25.00 = x 35.00 = x60.00 = x10.00 = x10.00 = x50.00 = x10.00 = x10.00 = x10.00 = x10.00 = x10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = /b , 0-G7 SUBTOTAL - PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =$ Spokane County Division of Buildings _ "- AIA ("moan ignal AgA_qn7g