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1993, 10-26 Permit App: 93010310 Mechanical Fixtures
MECHANICAL PEP..MIT'APPLICATION FORM Information Worksheet JOB STREET ADDRESS: J. SC /4 L(1,..“� CITY/STATE/ZIP:, �L/� ,, 4-4-2 PARCEL NUMBER: OWNER: A. 40,7..g.,4",e;) PHONE NUMBER: ,s(3y- aa9,3 MAILING ADDRESS:Q (Street) (City/State) (Zip) CONTRACTOR: 4h(2} -42-i .} 'L2- LICENSE NUMBER: ,Lkyz4.( (\ k ogcJ .(1 PHONE NUMBER: y(<� y%a c2 MAILING ADDRESS: C %19. 3S fv-oiCltate-v krn-i`. /,c' -' 9`I, /8 (Street) (Cit State) / (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOVE/INSERT . GAS WATER HEATER GAS!EQUIPMENT <1Q0 000 BTU (INCLUDES GAS EQUIPMENT+100,000 BTU DUCTWORK) GASPIPING (EA OUTLET) BOILER/REFRIG 1-100M BTU BOILER/REFRIG 1,0i 5500M,e1:;;,,„ BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG 1,0001-1,750Nv$TU's BOILER/REFRIG +1,750M BTU HEAT PUMP &AIR CONDITIONER 0 3 TONS HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT PUMP &.AIR CONDITIONER 15 30 TONSZ HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMP &`AIR CONDITIONER +50 TQN,S'". VENTILATING FANS EVA2ORATIVE COOLERS '! TYPE I HOOD (PER 12' OR 12 TYPE II HOOD CLOTHES DRYER RANGE GAS LOG MISCELLANEOUS (NOT>COVERED ELSEWHERE:: UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED GAS APPLIANCE>400`000 BTU'' USED APPLIANCE <400,000 BTU USED APPLIANCE>400'000 BT : AIR HANDLER <10,000 CFM AIR HANDLER'>10 000 -:CFM Z NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE`Ic\a\ e_c Spokane County Division of Buildings NUMBER OF UNITS X EACH UNIT I = AMOUNT x 10.00 = x25.00 = x 10.00 = x 12.00 = x 15.00 = x 1.00 = x 12.00 = x20.00 = 'x25.00 = x 35.00 = x60.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 =- x 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 = x50.00 = x100.00 = x 12.00 = x 15.00 = 5!Do ,.-}? Do .+/. SUBTOTAL $ .26. 00 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =$ 157,00