1991, 10-17 Permit App: 91006888 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: -1/6'
CITY/STATE21P;,�, - <2d.Z9r,,Z��1 2 7 --PARCEL NUMBER: 15e-
OWNER,
5COWNER, A "71 PHONE NUMBER: 9
MAILING ADDRESS:
(Street)
(City/State)
CONTRACTOR: Heat Transfer Inc. LICENSE NUMBER
PHONE NUMBER
(zip)
Heatti-1881n
328-3400
MAILING ADDRESS: N. 1008 Ruby Spokane, WA 99202
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
NOTE: MINIMUM PERMIT FEE IS $35.00
a
SIGNATURE
(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 =
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 =
SUBTOTAL
$
PLUS: PROCESSING FEE
+$ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_ $
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675