1993, 04-08 Permit App: 93002289 Mechanical FixturesqSo9L.0221 :"
M fru.nTel MECHANICAL PERMIT APPLICATION FORM A 3- -2..-as1' \ L- ( (:j-` L Information Worksheet
JOB STREET ADDRESS. C .'r)D4-s .EDF'.JCX2L J 4sQ3
CITY/STATEEIZIP: 044NE PARCEL NUMBER:
OWNER: n,DL PHONE NUMBER:
MAILING ADDRESS:
''`
(Street) (City/State) (Zip)
CONTRACTOR: R IkR4 1iS LICENSE NUMBER: IeRweem4 /04' 80-)
PHONE NUMBER: 1718 i - / 405
MAILING ADDRESS: B. /%Z3 1 4AZ/,S eSsfamAnt& en ao7
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
W.00ASTOVE'flEt?T . °£<;«
GAS WATER HEATER
GWEOpIA ENtV00We(NGt` ip„F�S
GAS EQUIPMENT+100,000 BTU DUCTWORK)
°9AS,RIPIN9:{49IJTI
BOILER/REFRIG 1-100M BTU
131!4:iwR(AEFFiICsiY01 57.10
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG +1,750M BTU
HEAT PUAAP $i<'f,1lf3 CO bitiO Ef gfTO S '"`" :3
sll a�n
HEAT PUMP & AIR CONDITIONER 3-15 TONS
IKEAr P ICIPI i SCONRI.7 o
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT:PUM.P:&A(R CONPIT)p""" R:t .(7:214;' ;M
VENTILATING FANS
EV{ ROFieCtikT Obbt01St u
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
:T:Yo�..f�f>�aM�£�?�S;iS`f"%: k��'��`j.45��'�� h
CLOTHES DRYER
GAS LOG
M1SCE' EOU. s: OlitOWEREO-
T S Oat
UNLISTED GAS APPLIANCE <400,000 BTU
ULtNSTF.,E3. PPLIANCE
GAISm
USED APPLIANCE <400,000 BTU
USERAPPI:.fANG):?400�pOQ, 7
AIR HANDLER <10,000 CFM
AIRHAN DLER ?:I.O;000;CF
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x10.00 =_
x12.00 =
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 =
C�PO
r�.00
c. . 00
SUBTOTAL
$ at -I-0)
PLUS: PROCESSING FEE
+ $ 25 00
EQUALS: TOTAL PERMIT
FEE DUE
= $ La (Y)
/0260 Spokane County Division of Buildings
West $393 Broadway Avenue Snnkane. WA 999Rn r5ng\ 4FF_za7C