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1993, 10-14 Permit App: 93009754 Mechanical Fixturesi MECHANICAL PERMIT APOLICATION FORM t( 11 h� /^^ D InformationpWorksheet 4�'S V1 JOB STREET ADDRESS: L %i g CITY/STATE/ZIP:/�5f,. e_ - %/i1 - ?7 n C PARCEL NUMBER: OWNER: I I 1 a)? / s • meq PHONE NUMBER: �� G - �o °1 g MAILING ADDRESS: f ^ / (Street) !' . (City/State) ^ (Zip) CONTRACTOR:JV D- T l.rt a LICENSE NUMBER: NDEn c/7 //A(7 7 6 L PHONE NUMBER:53 y— 1119 75" MAILING ADDRESS: (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) -WOODSTOVE/INSERT ; :: GAS WATER HEATER GAS. EQUIPMENT 'c100,0t)0„BTU (INCLUDES GAS EQUIPMENT+100,000 BTU DUCTWORK) G,AS; PIPING (EA_O,UTI:ET).:. SOILER/REFRIG 1-100M BTU BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG 1.,0001:-1:,750M::BTU:;:::..` BOILER/REFRIG +1,750M BTU HEALPUMP & AIR.CONDITIONER'0-3 TONS:: HEAT'PUMP &AIR CONDITIONER 3-15 TONS HEAT PUMP'& AIR CONDITIONER 15-3U TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT. PUMP & AIR CONDITIONER'+50 TONS. VENTILATING FANS EVAPORATIVE COOLER$::: ;: TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE`!I HOOb .,' CLOTHES DRYER RANGE:: GAS LOG 'MISCELLANEOUS (NOT COVERED: ELSEWHERE ' UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED GAS APPLIANCE >400,000 BTU. USED APPLIANCE <400,000 BTU USED APPLIANCE AIR HANDLER <10,000 CFM AIR; HANDLER >10,000: CFM NOTE: MINIMUM PERMIT FEE IS $35.00 (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x10.00 = x12.00 = x 15.00 = x1.00 = x 12.00 = x20.00 = x 25.00 = x 35:00 = x 60:00 = / /a, op / /0 o0 I 1of - - , -:A.1.• .1'. x 12.00 = -._. - _- . - ._...- x20.00 = X 25.00 = x35.00= x 60.00 = x 10.00 = x 10.00 = x 50.00 = x 10.00 = x 10.00 = x10.00 = x 10.00 = x 1,0.00 = x50.'O0 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00. =. - -- - SUBTOTAL ' ' ; •;`. $ ')_ 3.00_ PLUS: PROCESSING -FEE •- +$ 25.00.. EQUALS: TOTAL PERMIT FEE DUE ... =$ 'I/ r, op SIGNATURE/(644 _— /T7 Spokane County Division of Buildings West 1303 ''way Avenue Spokane, WA 99260 (509) 456-3675