1990, 08-07 Permit App: 90003789 ACSPOKANE COUNTY DEPARTMgNT OF BUILDING AND SAFETY
W. 1303 BROADWAY AVENUE
SPOKANE, WASHINGTON 99260
(509) 456-3675
I certify that I have examined this permit/application, state that the information contained in it and submitted by me or my agent to compile said permit/application is true
provisions s onscinand cluded here n and agree to comply with same. All provisions of laws and ordinances govern. In addition, I have read ding this rtype of work wstand the ill be complied with whether specified
herein olunderstand
that the issuance of this permit/applicationt subsequent inspection
Occupancy
giverued to
authority to violate or cancel the provisions of any state or local law regulating construction, or as a warranty of conformance with the provisions of any statshall not be e or local
laws regulating construction. ppLICATION
SIGNATURE OF gATE
OWNER OR AGENT
PROJECT NUMBER- 90003789
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AIR
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t'CONTACT NAME= MIKE THOMSON ..zFRONT= I{� '
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PHONE- 509 92C7
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QUANTITY
FEE AMOUNT
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RECEIPT4 PAYMENT AMOUNT
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.00 TOTAL PAID= 00
AmuUNT AMOUNT PAID AMOUNT OWING
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37.00 37,00 ,00
-'{fit.;!•'!?::.N}. DAIL
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TOTAL DUE=
PERMIT TYPE
........................
MECHANICAL PRMT
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MECHOIC& PR T AP` UCATION FORM
Information Worksheet
JOB STREET ADDRESS : 2. /6,,30/ .4077 12,eG ,d L 1
.5-4
CITY/STATE/ZIP.. ���� Q • �` 751
PARCEL NUMBER. ( "'" 6 //
OWNER: Irji L2 I er-i- ..5 C
PHONE NUMBER: 9 c $ 3 21
MAX LING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: pip. Ua 1 IAa4 I' LICENSE NUMBER: /9/ r� r Al/Off
owe
MAILING ADDRESS: %% Ste/
(Street)
MECHANIC
DESCRIPTION
PHONE NUMBER: 51,2i00/1
Cs
(City/State)
FEE SCHEDULE
SOF MRE S F UNIT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER _ ITU
HEATING EQUIPMENT -<100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (EA OUTLET)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU _
REFRIG 501-1,000M BTU-
REFRIG
_
REFRIG 1,001-1,75pM BTU_ _ _ - r
REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0-3 TONS
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)
TYPE II HOOD.
CLOTHES DRYER
RANGEGAS 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
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
ea,/
(Zip)'
AMOUNT
x$10.00 =
x 25.00
x 10.00 =
x 12.00 =
x 15.00 =
x 1.00 =
x12.00,
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
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 =
$ /a2 .o a
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
FEE DUE
+ $ 25.00
= $
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675