1990, 04-16 Permit App: 90001493 ACMECHANICAL PERMIT APPLICATION FORM
1htotmation Worksheet
JOE sTnEEt AbbttESS ! / / 3 / q /2E
CITY/STATE/'LIP! .,,, PARCEL NUMBER:
OWNER!; 15:W,77, . '.4/4 CRo i.27
MAILIffd ''Abb SS: -Slime kA�ai c '4 ?420 G
(Street) (City/State) (Zip)
CONTRACtOR'.. ttANNtit PURNAC1 t t'USL, LICENSE NUMBER! BANNI:FF378NT
PHONE NUMBER! 9 �- '- 7 3 8 a
CONTACt r f(S LtlNtt
MAILIHG Abbt2E86! , Pb,. !OX 4346
.PHONE NUMBER! 535-1711
(Street)
SPOKANE, WASHINGTON on'rj'
(City/State)
MEc11ANICAL WoRxsHEET/FEE SCfEDTJLE
HOMER X EACH
OF UNITS UNIT
tl2tdAt IGH
(Zip)
= AMOUNT
DUCTWOP# §'1§1EM ,
w000sTOVEJINSEJtm,
GAS WATER HPA'1E1 _ _
HEATING EQVIPMENt- 1fy0, 000 BTU
HEATING tOOTPMEMT 41150 j bO0 BTU
GAS PIPING (1-2 4 bt) 'LE 'S )
GAS PIT/NG (5=, 6 t MORE t tACt1 !) _ 'Anil')
REFRIG 1=1OOM SPU (HOT Aid OE -HEAT PUMP)
REFRIG 1014i86bM H'FU.
REFRIG 5o1A1 O0 M HTC _
REFRIG 1, 1.I,'�55M BTU,
REFRIG +1,750M a'1 J ,..::�.
HEAT PUMP & Aft e0HtifP1OfEf d -J 'tons
HEAT PUMP & Aft COMbitfont J -i5 'fiats
HEAT PUMP & Aft e01lI32''tbttEn 15-J0 Tolls
HEAP PUMP & ATT , ebMnftfoHEtt J6-50 Tons
HEAT PtJMP & Aft UORIJITIbfEtt ,4 5 'SONS '
VENTILA'i'IIi't
EVAponA'1 IVA'. ebCL1~RS,. a.. .A. .
TYPE 1 HOW -MA -121 O 12 t'TNi Ot t1ooD)
TYPE If H000- `:�►° `9ri z
cLOTHE8-
R11NGE� 'Att ray is � L)
-
GAS 1).A11.41% w ',�.T .dr � :.a ,� «G �. � .,....,,,, - -
MIScELL gUs (N T 'Cc V1"ID ELSEWt11;>tE
UNLIS?1ub ITh. APPLTAi1 4OO t t O8 ttO
UNLISTEt GA9. AP LtAMkg M60,060 ar'tJ
USED APPttAa'Cr 1400006 � Ham. -.
USED APPLUANei . 4t O, O86 - MU
AIR t1ANbtEP ti r'O enl _ - -
AIR HANbt )101065 CrM' . <,
�-
ma! . NMS Ph11u1tv Pgt in ti+; no
5tr71 JP
1
sUHt0TAL
x$10.00 =
X 25.00 =
X 10.00 =
X 12.00 =
x 15.00 =
X 4.00 =
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.Oo =
X 12.00 =
X 15.00 =
/,Z,,-oo
$
PLUS! PROCESSING FEE
+ $ 25.00
EQUALS! TOTAL PERMIT
FEE DUE
Spokane County .DOnnttlnent of Building and Safety
Wast 1303 Broadway avenue ; Spokane, WA 09260 (509) 456-3675