1993, 11-03 Permit App: 93010517 Mechanical Fixtures5 Z.330LL
0/ MECHANICAL PERMIT APPLICATION FORM
In ornlalion Worksheet
�I/l,oadiaPn.� �I i
Ara 6'-14 C
JOB STREET ADD - S: '
_ it
�L/J •
CITY/STATE/
OWNER: ./
MAILING AD' ESS:
CONTRACTOR:
`13-1 c
•
ARCEL NUMBER:
PHONE NUMBER: (0 1->447.
l
(City/Stale) (Zip)
LICENSE NUMBER: AI R 7-7 ,1"-/ o 7 Jo
PHONE NUMBER: 9 /i S 9
MAILING ADORES ' 13 / 0/9 p i1�--� 6.04 . 1%) %3
(Street) ' (City/Slate) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
.OODSTOVE/INSERT 10
GAS WATER HEATER
IR:Mg>. 1O 000 UT.U:.(INCLUDES :::::E.
•�GwAsS �[�
EQUIPMENT�i���+u100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG +1 ,750M BTU
.Tia.••'' NQIIONE°
HEAT PUMP & AIR CONDITIONER 3-15 TONS
A.. .:Y • `I PI .,..ONER`15 30 TONS 'ran ta::
�� TI�
HEAT PUMP & AIR CONDITIONER 30-50 TONS
E P M lDI 'IQ!4 ISO -4.•-N•
VENTILATING FANS
•
TYPE I HOOD PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
GAS LOG
UNLISTED GAS APPUANCE <400,000 BTU
MaittrAtifittralleak91":,..oo ............. T:U
USED APPUANCE <400,000 BTU
020"A 11.10e
AIR HANDLER <10,000 CFM
its
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURES/� `� a ' %l9 -
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x25.00 -
/
x 10.00 -
/6.6o
X12.00 -
/,, 00
x 15.00 -
x 1.00 -
----Z-0 6
x 12.00 -
x 20.00 -
x 25.00 =
x 35.00 -
x 60.00 a
x 12.00 =
x 20.00 a
x 25.00 -
x 35.00 -
x60.00 -
x 10.00 =
x10.00 -
x 50.00 =
x 10.00 -
x 10.00 =
X 10.00 =
X 10.00 -
x10.00 -
x 50.00 -
x100.00 =
x 50.00 -
x100.00 -
x 12.00 -
x 15.00 -
SUBTOTAL
$ 4 , Jam,
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 4/C/• oo
Spokane County Division of Buildings
West OZproadwny Avoir n Spokane, WA 99211(1 (50914Y; :m7f;