1993, 10-27 Permit App: 93010370 Mechanical FixturesMECHANICAL PERMIT A=)PLICATION FORM
Information Worksheet
JOB STREET ADDRESS: S 4 2 I$ Ijrea+ YlC
CITY/STATE/ZIP: i?j)c9 e- gQJO? PARCEL NUMBER:
OWNER:e-\Lc.o, PI 00 PHONE NUMBER: 4 7 -6-66-?MAILING ADDRESS: jj
(Street) (City/State) (Zip)
CONTRACTOR: A h,ict vr2w5 ee- Lh.i eu, I. LICENSE NUMBER: AND KI, } 0311 3
G' f PHONE NUMBER: 471,- 3 X44 4-Q� '- 6 L 3
G
MAILING ADDRESS: I`S^ o 2 b� n I. 54/9 -v`
a K4-& LJa-5k 2, Vc57
(Street) v (City/State) (Zip)
MECHANICAL WORK
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER
o/a::arM:y..wi:•firrf•arr►•�.w'3s ::•A•i►•%ii:1.Ur:iY!Y�l::�:rJfYtA:l:::Y�f!+i!!!C.'•i<ji`;'
EQUIPMENT +100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
.
BOILER/REFRIG 501-1,000M BTU
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BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 3-15 TONS
•
HEAT PUMP & AIR CONDITIONER 30-50 TONS
•
VENTILATING FANS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
UNLISTED GAS APPLIANCE <400,000 BTU
USED APPLIANCE <400,000 BTU
AIR HANDLER <10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
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 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/a. 06
/2.0-0
Z. C7 --C.
SUBTOTAL
$ 2 1-4,60
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
q
= $ 4 I,,CZ
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675