1993, 02-26 Permit App: 93001090 Mechanical FixturesJOB STREET DRESS:
CITY/STATE/ P:N3p0 , (,LSV) • a 9 I A PARCEL NUMBER: /��/
OWNER: CL/U1 (I'1 7b A_ PHONE NUMBER: / - 7•e-5/&
MAILING ADDRESS:
MECHANICAL PERMIT APPLICATION FORM
Inforrnatic :•Worksheet
-,- 1090
--5Z3
CONTRACTOR: ON Co
MAILING ADDRESS: F.
dStreet)
ee_trtaff
5/03 i��2r
(Street)
(City/State)
(Zip)
LICENSE NUMBER: ANCN4R( TU.
PHONE NUMBER:,_ 3Y- LIC17
q97-/Z--
(Street)
9Z/z
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT '[•
GAS WATER HEATER
GAS, EQUIPMENT_<100;000. BTU (INCLUDES:':' _..,'.. ;
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS.PIPING,(EAOUTLE)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 101-500M BTU: '
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,0001-1,750M BTU"
BOILER/REFRIG +1,750M BTU
HEAT•PUMP & AIR CONDITIONER 0-3
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP& AIR CONDITIONER'15-30
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT: PUMP & AIR-CONDITIONER,+50 TONS
VENTILATING FANS
EVAPORATI,VECOOLERS -.:. .:".`•
.. s:...`:' .:...::.:.:::
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOP. `:-:' ` - ..::
CLOTHES DRYER
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
UGNSTED,GAS APPLIANCE >400,000 BTU.
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER>10,000CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x10.00 =
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 1,0:00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
N
/) a
/j_ //U
\PN.,N.N.N,
5( (Th
SUBTOTAL
$ cp. a
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ SR, 60
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675