1991, 11-08 Permit App: 91007694 Mechaical Fixtures-61±1-1 MECHANICAL PERM[TAPPLICATION FORM
1kf-, d� Information Worksheet
JOB STREET ADDRESS: _.
CITY/STA
TE21P: S' o k twt q ?do% PARCEL NUMBER:
OWNER: a PQ R t c kale d S Or., PHONE NUMBER: 961 b 8 9 3 e
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: MSM INC (MARTIN SHEET METAL INCLICENSE NUMBER:MA RT IS M170KW /C600 470 101
PHONE NUMBER: 924-8088
MAILING ADDRESSBLDG 103 SPOKANE INDUSTRIAL PARK SPOKANE, WA 99216-1609
(Zip)
DESCRIPTION
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
OF UNITS
XEACH
UNIT
= AMOUNT
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
..W OODSTOVE/INSERT /-
GAS WATER HEATER
GASEQUIPMENT<100000 BTU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLI=1)
BOILER/REFRIG 1-100M BTU
BOILERIREPR1G 7;01
EOILER/REFRIG 501-1,000M ETU
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0 TONS
HEAT PUM? & AIR CONDITIONER 3-15 TONS
HEAT Pl)M & AIR CONDI iHNHR 33-50 TONS
HEAT PUMP 8AIR CONDITIONER +50 TONS
VENTILATING FANS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
P
CLOTHES DRYER
RANGE>
GAS LOG
MISCELLANEOUS ( NOT'COVEREDELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANCE
USED APPLIANCE <400,000 BTU
.USEOPAPp'`L'1ANCE`� 'o'or000<BTt
AIR HANDLER <10,000 CFM
'AIRiiANDLER>10 OOOrCFM : NG &SAF '
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA ' 99260 (509) 456-3675
x 10.00 =
x25.00 =
x 10.00 =
x12_00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.
x 60.00 =
x12.00 =
x 20.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x10.00 =
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 =
SUBTOTAL
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
FEE DUE
$
+ $ 25.00
$9'