1993, 06-16 Permit App: 93004661 Mechanical FixturesMECHANICAL PERMIT:A)-9LICATION FORM
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Information Worksheet
JOB STREET ADDRESS: //942 -E0 .'%/LC C.4'CJ
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CITY/STATE/ZIP: ,t4 , 4 . 992o PARCEL NUMBER: 1-16-01Q1//062
OWNER:�,_-0_&yU7%o/77) /.[ jO J
MAILING ADDRESS:
PHONE NUMBER:
(Street) (City/State) (Zip)
CONTRACTOR: f,CHT-1 CC) B4 -G -M V..-cLICENSE NUMBER: R i 0 Z.
PHONE NUMBER: q2 -i - 5t o c_,
MAILING ADDRESS: a \\ S lL \ Rn S F t e�cQ !4.3
(Street)
MECHANICAL WORKSHEET/FEE SCHEDULE
4cc la.L
(Ci y/State) (Zip)
NUMBER X EACH
DESCRIPTION OF UNITS UNIT
= 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 & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
VENTILATING FANS
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD1
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
/
/
x$10.00
x 25.00
x 10.00
x 12.00
x 15.00
x 4.00
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
/0 . 0 C)
/�i•06
OU
/Q. 00
NOTE: MINIM PERMIT FEE IS $35.00
SIGNATURE GIl/A�¢
„_ - Spokane County Department of Building and Safety_
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE