1993, 04-13 Permit App: 93002418 Mechanical FixturesJOB STREET ADDRESS: 4 -'6, -Li (7tilL0-4Q 1/2010
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CITY/STATE/ZIP: -12tjt"-§4crk4i LAJA PARCEL NUMBER:
, c)(9co co MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
OWNER: ge;:4tA
MAILING ADDRESS:
CONTRACTOR:
rq1(1
PHONE NUMBER:
(Street)
SAI 144-0,
MAILING ADDRESS: S
(Street
,2,118
51-3
(City/State) (Zip)
LICENSE NUMBER: 142//27/4/42
PHONE NUMBER:
V14-0eOtt5 CzkGte-s tA) ergove
(City/State) (Zip)
MECHANICAL
DESCRIPTION
WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000
HEATING EQUIPMENT +100,000
GAS PIPING (EA OUTLET)
BTU
BTU
REFRIG 1-100M BTU (NOT A/C
REFRIG 101-500M BTU
OR HEAT PUMP)
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
VENTILATING FANS
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12'
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
PTN. OF HOOD)
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
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM
1
.1
= AMOUNT
x$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
x 25.00 =
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 =
x100.00 =
x 12.00 =
x 15.00 =
/0 -
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERNIT
FEE DUE
Spokane County Department of Building_ and Safe
West 1303 Broadway Avenue Spokane, WA 99260 (5
9
456-3675