1990, 09-28 Permit App: 90004977 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM /2srf -
Irformsa"tion Worksheet
JOB STREET ADDRESS: 703 3 , AV , Yo r r Pd,/,,' 7,' 72 1 L rj-S`)
I\
CITY/STATE/ZIP:J c 7 p ,, (_1)49,5,PARCEL NUMBER:
1 ^_ n PHONE NUMBER: Vc28 _ ` C� �- (o
)., OWNER: �s�.Q;c A -P . (" CL. CY ( P.C�" n n
a. MAILING ADDRESS: 70 3 0/L) , i 4 /C Vi�-f� -rte i W441 Q9 6
I (Street) City/State) (Zip) -
0
3\ CONTRACTOR: j2e/ �/ ,de(../? �t__ kc' - 19n- �P 3 7o2/()T
ovoi
MAILING ADDRESS:
( x_ 376-7
(Street)
LICENSE NUMBER:
PHONE NUMBER:
9T9-//) k 34/
4t4U, 0),41
City/State) (Zip)
MECHANICAL WORKSHEET/FEE•SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
= AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (1 --4 OUTLETS)
GAS PIING (5 OR MORE. EACH:)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP ' &
HEAT PUMP &
VENTILATING
AIR CONDITIONER 0-3 TONS _
AIR CONDITIONER 3-15 TONS
AIR CONDITIONE t'. 15-30 TONS
AIR CONDITIONER 30-50 TONS
AIR CONDITIONER +50 TONS _
FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER_ J2' OR 12' P'TN.. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
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
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.99 =
x
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 =
OC
/.00
NOTE: M IUM P T FEE IS $35.00
SIGNATURE re
SUBTOTAL
$ /3_0 -
PLUS:
3_0 --
PLUS: PROCESSING FEE
+ S 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane Cou Department of Building and Safe
West 1303 Broadway Avenue Spokane. WA 99260 (509) 456-3675