1991, 11-27 Permit App: 91008296 Mechanical Fixtures,bry qct
JOB STREET ADDRESS: ` cce)
MECHANIC
ERM' 'APPLICATION FORM''
reformation Worksheet
PARCEL NUMBER:
PHONE NUMBER
CITY/STATE/ZIP:` c 44hfi Ii
OWNER: kle:///%'- (i
MAILING ADDRESS: 4-nv2'''
CONTRACTOR:
(Street)
Heat Transfer In
MAILING ADPRESS: ' N _ 1008 Ruby
''(Street)
DESCRIPTION
(City/State)
LICENSE NUMBER:`"
PHONE NUMBER: 8 13400
''Spokane, WA
99202
c.29
�.
(ZiP)
atti-1881n
MECHANICAL WORK
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
GAS WATER HEATER..'
SGA QL' ('PK 'E i Mair �'( E1 E.
GAS EQUIPMENT +100,000 BTU DUCTWORK).
GAS PIPING (EAOTLE ;
BOILER/REFRIG OOM BTU
a s
a<a
BOIItR/pEp a< OnN(`I'IW s fids}$
BOILER/REFRIG 501-1,000M BTU
`BOILERIRE RIG` 'i?i° '(- Y 777 > Y{v a:::<
BOILER/REFRIG +1,750M BTU qtr:
HEAT PUMP & AIf1 ONDITIONER 0 ' O S
HEAT PUMP A AIR CONDITIONER 3-15 TONS
HEAT PUMP}& All O(`IDITIONE; t5R3C1•
HEAT PUMP & AIR CONDITIONER 30-50 TONS'
HEAT PUMP & AIR CONDITIONER +50 TCS ,§12 ,.,N>2
VENTILATING FANS
EVAPORATINECOOLE "�S�v,zv `
{:.:.. .......... ....::.:.. .:.....:::::::
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
RA
-.. .::070E
::.:.....:.7:{:::.,.::::..:.:3Sr:• a`u.. �.:.,,:...v:,....ASca�t•::9aiw•:.�.
GAS LOG
u rS EL iEocfsw .170:•,
v`a4,
UNLISTED GAS APPLIANCE <400,000 BTU
ffULIN5TED GAS�APP SIA. CF 0�,0 _
i:v: i:::.v•.`ai:. ii .vVY.: :W'•• �w, •••M�Gv .:tiv%+R4,
USED APPLIANCE <400,000 BTU
rOgi. 2aa:M....•. a. vvxv:• •:sYc •.ow:3.,
AIR HANDLER <10,000 CFM
NOV 2 ?,1991
NOTE: MINIMUM PERMIT FEE IsPig15 - ":SAFETY
SIGNATURE,
(City/State)
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x1000"s �.
x 25.00
x 10.00 _•,
x 12.00 -
x 15.00
x t.00 =
x 12.00 -
x 20.00 = ',-
x 25.00 =
x 35.00 =
x60.00 =
x12.00 =:•.
x20.00 = -`..
x25.00 =
x35.00="
x 60.00 =
X 10.00 =
X 10.00 =
x 50.00 =
x 10.00 =
x10.00 =
x 10.00 a,
x 10.00 =
x10.00:+'
x 50.00 V=
x100.00 =
x 50.00
x100.00 -
x12.00 _
x15.00 =
/cam
+� c21-'
-
•
SUBTOTAL
$
PLUS: PROCESSING FEE '
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
r�9'
= $ �"
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675