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1992, 10-21 Permit App: 92009207 Mechanical Fixtures•j MECHANICAL PERMIT APPLICATION FORM L i /', _,5 Information Worksheet "j 'JOB STREET ADDRESS: .S r 7(OR 619 440 CITY/STATE/ZIP: SOON, a.4 PARCEL NUMBER: OWNER: t4-40-il) PHONE NUMBER: MAILING ADDRESS: S>y-'l'/e (Street) (City/State) (Zip) CONTRACTOR: l/? 7/ (.�/k1/4( j LICENSE NUMBER: /t/ -1 -70e ---S <!6J/C9 _ PHONE NUMBER: - QZZ `ZODo MAILING ADDRESS: F. /6 /1.2(9 6- e-1 5)00/G /(4,1' 9-7 ZGz (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE cRSTCC ,Q fV qzz- z6R6 X33 DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) T V N GAS WATER HEATER ::.:;.:ilk: •:.:,<:::,:::::.,,:. �,.;�.::;.;:;:..::;,:.,::.;,,.::.::.:>,.::::,::,.;.:_:> �::; �.,....:.:..::::>:>:::::::.,.:..,.<::::;:..>': GAS EQUIPMENT +100,000 BTU DUCTWORK) .................................. . BOILER/REFRIG 1-100M BTU E.O1 1 E :: � ::1: . ! .> <> :.:::::::::.. . BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG +1,750M BTU :•: ::. �::.:: .ilii:. i?i'...iiiiiiiiY. •.. }: : is ii::: i:• iiii i:?iii: ii::.::::::::? :.:::.:::::.::: •.:..:..::: HEAT PUMP & AIR CONDITIONER 3-15 TONS -,-..r:.::.�::.,_:,.r,...:.:,r-:•;,.-t w.w,.r.. HEAT PUMP & AIR CONDITIONER 30-50 TONS VENTILATING FANS TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) ........... :�i..� �%IM� W tiL ri: f:i'iit'Jw: i�►';isi:::(TT:::L.isi^'f..iiiii:4:•i:::iiiisii:<:[::::::.�::::::.:.:..:::::::::::::::::::::. CLOTHES DRYER GAS LOG UNLISTED GAS APPLIANCE <400,000 BTU 1i..;... ., :..;._.....::..',<>> USED APPLIANCE <400,000 BTU AIR HANDLER <10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE U NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x 10.00 = / x 12.00 = a -- x 15.00 = lx 1.00 = ',lr -� x 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 12.00 = x20.00 = x 25.00 = x 35.00 = x 60.00 = x 10.00 = x1 . 0 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 = SUBTOTAL $ / PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ 38z Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675