1992, 09-08 Permit App: 92007315 Mechanical FixtureslA9e2:1y; ,;15
ls-S v 3 k
JOB STREET ADDRESS:
CITY/STATE/ZIP: t
MECHANICAL PERMIT APPLICATION FORM
.Iriformation',FiorksYieet ��
OWNER:.
/00 PARCEL NUMBER:
me ,t6/2er
PHONE NUMBER: 9-2 --7//7
(City/State) (Zip)
LICENSE NUMBER: "W ma -Ta IA -A- no n q z.
MAILING ADDRESS: 4c/r
(Street)
CONTRACTOR: gA+�Yr ,n, - 4-4s +-AA.s.,_ ..�_
1
MAILING ADDRESS: -C -\l6 tL - $$v..St eQ .4 II
(Street)
PHONE NUMBER: 4' tt-to o 0
.441-..s itir_ \h- 9_4znSo
(11,y/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE•.
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 II HOOD (PER 12' OR 12' PTN. OF HOOD)
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
7
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 =
30 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 =
/O.o
/z- OD
c. Owl
NOTE: MINIMUM PpEE IS $35.00
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Department of Building and Safety
wane 4 117 n. --a--- s.._ .._ n r. -_ .... nnnen 'emit ACC ole -re
+ $ 25.00
= $ 0
-P
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