1993, 09-23 Permit App: 93008647 Mechanical FixturesJOB STREET ADDRESS:
CITY/STAT ZIP: .ab /..t r
OWNER: J49,
MAILING ADDRESS. 4-120-4vvz e-•
MECHANICAL PERMIT APPLICATION FORM
Inlegoation lWonrkLsheeet D
81/0 � . /y C I-� Lc L�
Q � % Z PARCEL NUMBER:
PHONE NUMBER:
i
9A4-94/41%
`j� (street) (Clty/State) (Zip)
CONTRACTOR 9/ �j LICENSE NUMBER: NO.Tt+ A v rI 2,TO
22 , f Q PHONE NU BER: /Qc 44 f �%
MAILING ADDRESS �J `/ / a -ice c 99-/3
DESCRIPTION
(Street)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
?WOODSTQ.VE/INSERT ::- ::::a?:;;:::
GAS WATER HEATER
PAT.P.;gQpJPMENT, `I00,000;HTU (INCLUDES:_;:;;
GAS EQUIPMENT +100,000 BTU DUCTWORK)
!GAS .PIPI 9.( 4:PUTIET);, r,:'ti ..:.:.;::,'`;:' ..
BOILER/REFRIG 1-100M BTU
BO1LER/REFRIG;I0l 5OOM'BTU +:
BOILER/REFRIG 501-1,000M BTU
•
BOILER/REFRIG +1,750M BTU
:H. 0AtkUMS'A.I PONOI.TIONER 0 3;.TONS.
HEAT PUMP & AIR CONDITIONER 3-15 TONS
IIT T„:PUM.B aCONQITIONEfi 15-30 TONS ...;,
HEAT PUMP 8 AIR CONDITIONER 30-50 TONS
(R.FATfUMP &AII3 CONDITIONER'+5l1 TONS: • >"
VENTILATING FANS
TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD)
PJ lIM1J Clan rx
fir
CLOTHES DRYER
NtAgniEW
GAS LOG
MISG.P 1 g04.01#400YgREC ELSEWHPR
UNLISTED GAS APPLIANCE <400,000 BTU
JUN%TERr�al!?iM PUItyNCE>400;000:BTU. -
USED APPLIANCE <400,000 BTU
r
U$'EC I~)Aillglt3"4 e0Q0;BTV
AIR HANDLER <10,000 CFM
AIf>:i1A6R:I 9.?: IMPFM<g":;;;
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x25.00 =
/
x 10.00 =
/0-00
/
x 12.00 =
id .00
x 15.00 .
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x35.00=
x60.00 =
x12.00 =
x 20.00 =
x 25.00 =
x 35.00 •
x 60.00 =
x 10.00 =
x 10.00 a
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 -
fl . O O
SUBTOTAL
$ & 410
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_$/Q,00
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456--3675