1994, 05-02 Permit App: 94003811 Mechanical FixturesMECHANICAL PERtIiT APPLICATION FORM t�
Information Worksheet q4 - 3 v
JOB STREET ADDRESS: 4 /.3 3 o 5/11 ,/,,, s , (V ,-r-'
CITY/STATE//ZIP:/c)0A.-lonr,ta 77 of / 6 PARCEL NUMBER: ,.
OWNER: �j�r� J PHONE NUMBER: 9,5 4/-_3/3
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: A fr-r-r4'7-trJ�i-° 4 LICENSE NUMBER: A) D R C 0 /1 AA 07 1/7 J
/ PHONE NUMBER:D5 7 -(i - i S
l 7
MAILING ADDRESS: £ 5 1 o 3 T- vim, S�-�✓�(2/tm, a
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
:WOODS70VE/INScRT::
GAS WATER HEATER
GAS;EQUIPMENT<100;000'ETU: (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
;.GAS.PIPING .(EAOUTLET) ..:: :;':': x ,•
BOILER/REFRIG 1-100M BTU
901LER/REFFlIG•101`7-500M STU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,0001-1,750MBTU;,„ ':; (' j' ....
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 3-15 TONS
iHEAT,:PUMP& AIR CONDITIONEP`i 5-30:TONS:;
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT:PUMP'& AIR CONDITIONER +50,TONS
VENTILATING FANS
EVAPORATIVE,CO0LEI4S
TYPE I HOOD (PER 12' OR 12' PIN. OF HOOD)
:Tl'PEEII:NOOD . ,
CLOTHES DRYER
GAS LOG
M!SCELLANEQUS.(NOT:COVERED ELSEWHERE:
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED:GAS APPLIANCE>400,000:BTU :.:.
USED APPLIANCE <400,000 BTU
'USED APPLIANCE >400,000 BTU ?
AIR HANDLER <10,000 CFM
AIR ?10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE k1/4 -ft
Spokane County Division of Buildings
. 'way Avenue Spokane, WA 99260 (509) 456-3675
West 13(
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 =
x12.00 =
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.b0 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/0,00
X500
/
.2
.�. 0 o
SUBTOTAL
$ A),nO
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ 00D