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1992, 10-21 Permit App: 92009202 Mechanical FixturesJOB STREET ADDRESS: CITY/STATE/ZIP: (51,1►,: 1 nip OWNER: Ip ,Ue4;4er& iu MECHANICAL PERMIT APPDCA11ON FORM Information Worksheet �%n� �;Z r' Ludt Ile 81/40 PARCEL NUMBER: PHONE NUMBER: cpq' MAILING ADDRESS: (City/State) CONTRACTOR: Heat Transfer Inc. LICENSE NUMBER: Heatti-188In (Street) (T p) PHONE NUMBER: 3 28-3400 MAILING ADDRESS: N. 1008 Ruby Spokane, WA 99202 (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOVE/INSERT .. GAS WATER HEATER GAS EQUIPMENT::<100;000 BTU:(INCLIJDES,'<) <; GAS EQUIPMENT+100,000 BTU DUCTWORK) GAS PIPING.(EA OUTLET) BOILER/REFRIG 1-100M BTU BOILER/REFRIG 101=500M8TU`:::.:; BOILER/REFRIG 501-1,000M BTU BOILERIREFRIG1.,0001.-t,750M BTU BOILER/REFRIG +1,750M BTU HEAT PUMP & AIR CONDITIONER 0-3 HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT PUMP: &.AIR_CONDITIONER 15-30. TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMP &AIR CONDITIONER +50 TONS; VENTILATING FANS EVAPORATIVE COOLERS •'• TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) CLOTHES DRYER 'RANGE `:` _ ` GAS LOG MISCELLANEOUS (NOTCOVEREO ELSEWHERE- I: >'. UNLISTED GAS APPLIANCE <400,000 BTU .ULINSTED:GAS'APPUANCE>400,000 BTU.: USED APPLIANCE <400,000 BTU USED APPUANCE�z40Q,000 BTU AIR HANDLER <10,000 CFM AIR:HANDLER>101000:CFM :>` ;::'.s::'.i NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = ' x 10.00 = /0 . Q? x 12.00 = /„),j)0 x 15.00 = ri 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 = x10.00 = x 50.00 = x100.00 = aY" ea x 50.00 = x100.00 = x 12.00 = x15.00 = SUBTOTAL $7211 , 00 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT- (' q 156 FEE DUE $ 7 / Spokane Co my Division of Buildings West 1303 Broadway Avenue pokane, WA 99260 (509) 456-3675