1991, 09-27 Permit App: 91006310 Mechanical FixturesMECHANICAL PERMIT-APPL1CAT1ON FORM
Information Worksheet
JOB STREET ADDRESS: 5-/ b L o 7t/j
CI i i/STATE/ ZIP: Sfq,a(/-.k. c✓A y9pv(PARCEL NUMBER:
OWNER: /Tc' FF 11.4c4,1,peScN
PHONE NUMBER:
MAI LING ADDRESS : S - 3 5 / LU? 7
(Street)
CONTRACTOR:. l lie,61;::7 4»
9, , - 3y
(City/State)
(Zip)
LICENSE NUMBER: 1.4-S 1 31 Ai 44
PHONE NUMBER: "4-76-9- d cj
MAI LING ADDRESS : p- 71/3- ow .PA/S- /Z of
(Street)
Cit ediN1zv CcJ4 5/00,3
(City/Sate) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS ITNIT
.DESCRIPTION
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
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
REFRIG1,001-1,750M BTU
REFRIG +1,750M BTtJ
HEATPUMP & 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
RANGE
GAS 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
= 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 =
x20.00
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 =
/0 -
/5
la
NOTE: MI MUM IT FEE IS $35.00
SIGNATURE .4
SUBTOTAL
$ 37
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Department of Building_ and Safety
West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675