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HomeMy WebLinkAbout1992, 09-10 Permit App: 92007406 Heatera��• �5 o ( 21\ MECHANICAL PERMIT APPLICATION FORM �- O ; Ithoormation Worksheet (` JOB STREET ADDcESS' /3/(22 • t ✓ L+ �!(f�, Ltlao CITY/STATE/ZIPk,/77��%9 96/197/(;) PARCEL NUMBER: OWNER: 9a c`rt� flcd c/(/M� i PHONE NUMBER: 9.2 V-1/4072--) MAILING ADDRESS: (Street) CONTRACTOR: % %Q41 (/0 ..M1-1 MAILING ADDRESS: 6. VQ 3 77?E-A 1r (Street) (City/State) (Zip) LICENSE NUMBER: NOILf'O/-f%/%%,C PHONE NUMBER:,5R %C S. ‘09 9902/x. (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) GAS WATER HEATER :GAS EQUIPMENT<100,000 BTU'(INCLUDE$ !?i.`.:', GAS EQUIPMENT+100,000 BTU DUCTWORK) BOILER/REFRIG 1-100M BTU :BOILER/REFRIG 101'500M BTU' BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG 1;0001 1;750M BTU,. BOILER/REFRIG +1,750M BTU HEAT PUMP & AIR CONDITIONER, 0-3 TONS,iF7 ' ' '" HEAT PUMP & AIR CONDITIONER 3-15 TONS 'HEAT PUMP. & AIR CONDITIONER 15-30 HEAT PUMP & AIR CONDITIONER 30-50 TONS ;HEAT PUMP &AIR CONDITIONER X50 TONS.`.;;. VENTILATING FANS EVAPORATIVE COOLERS.. • TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE II HOOD °::.', ; ` CLOTHES DRYER RANGE..::':::,, . ,::... . . .:..:.. : .. GAS LOG ... .....:......:.........: . iMISCELLANEOUS_(NOT.COVERED:ELSEWHERE; UNLISTED GAS APPLIANCE <400,000 BTU 'ULINSTED,GAS APPLIANCE>400,000 BTU USED APPLIANCE <400,000 BTU U,SEDAPPLIANCE>400,000:BTU',:;;; AIR HANDLER <10,000 CFM :AIR HANDLER >10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE/ -e[4.4 / p/Fe (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x 10.00 = x 12.00 = 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 = x10.00 = x 50.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x 1,0.00 = xouo = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = A,(2_ /O SUBTOTAL $ PLUS: PROCESSING FEE - + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE ��//yy�� =$ k.52 </ Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675