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1992, 10-20 Permit App: 92009335 Mechanical Fixturesez • MECi-cANICAL PERMIT AP4-?1_1CATI ON FORM Information Worksheet -- - c133 3ric)115 . — - JOB STREET ADDRE-SS:• t\) Cf0--\\ y(--) _ „ • 901'N - • "f e G2SI3 10--20-(12- -atz (i C\ICA2 - PARCEL,NUMBER:- CITY!STATE/ZIP:AN.., PHONENUMBER: --a4Y1'21 - to?) - • r, MAILING ADDRESS:. OWNER: M (Street) CONTRACTOR•i_ 111 Heating, Inc. MAILING ADDRESS: DESCRIPTION !DUCTWORK (SEPARATE SYSTEMS) Li TER E. 204 Indiana - (Street) ( ty/S(ate) LICENSE NUMBER: PHONE NUMBER: 325-4505 - Spokane (CitylState) STURMI* 210 QF MECHANICAL WO ELEG I e o.sgPv A lfMeya'' Mahn 01, AS EQUIPMENT -I-100.000 BTU DUCTWORK) ' • 014i1,1—Eg ;ware 4•Pt BOILER1REFRIG 1-100M BTU " MtB0_1'4N isla5R/RF_PAI:. "10: BOILER/REFRIG 501— .0 hi _; le4,40 9011.1RMEFFIraf692.9.;11:33:55_0. e : BOILEFUREFRIG +1,750M BTU " ER GO: d'T'iO •!;-‘4"-- FiEAT4U'A HEAT PUMP &AIR CONOMONER 3-15 TONS 8,7ATESiG, '171'(.7.-EF7.7i757-3;p:, A -{1,77"- HEAT PUMP AIR CONDITIONER 30-50 TONS- - VENTILATING FANS OR 12" PTN..OF HOOD) 4 -fit JNiSTED GAS AP A STg.0.7 0 -AN PUAN CE<400, S AIR HANDLER . CF 1RIaMIER tiseD AP )E <4000 0,0 •-E4-4A No miNtmtim PERMIT FEE IS S35.00 SIGNATURE__ 9 9 207 (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x -tom . x25.00 = x10.00 = x12-00 ' 0 • IMMIIII x15.00 = x1.00 = 7.00 x 12..00 = . x 20.00 = - -.-,: -. x 25.00 = i• - - x3500 = x6000 = -- x 12_00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 10.00 = x-10.00 = x 50.00 = x 10.00 = 5(10.00 = x10.00 = E.' - - • x10.00 = z , - X 10. x50.00 = x100.00 x50.00 = x100.00 -.• X_12_00 .. .....,_ . SUBTOTAL PLUS: PROCESSING FEE" ' 25.00 EQUALS: TOTAL PERMIT FEE DUE