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1992, 06-22 Permit App: 92004581 Mechanical FixturesV°•17 t MECHANICAL PERMIT APPLICATION FORM ki kO � Information Worksheet tea- t[5$\ q0 57 JOB STREET ADDRESS: 3601 South Loretta Drive CITY/STATE/ZIP: Spokane, WA OWNER: Mike Mitchell 99206 MAILING ADDRESS: 3601 South Loretta PARCEL NUMBER: (509) 928-2372 - HM PHONE NUMBER: (509) 353-2504 - WK Drive (Street) CONTRACTOR: Steinmetz Heating & A/C Spokane, WA 99206 (City/State) (Zip) LICENSE NUMBER: STEINHA142KF PHONE NUMBER: (509) 922-2034 MAILING ADDRESS: 2114 North Pines Road, Suite 3 Spokane, WA 99206 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH OF UNITS UNIT DESCRIPTION DUCTWORK SYSTEM WOODSTOE/INSERT GAS WATER HEATER HEATING -EQUIPMENT <100,000 BTU HEATING EQUIPMENT +100,000 BTU GAS PIPING,(EA.OUTLET) REFRIG 1-100M BTU'4NOT A/C OR HEAT PUMP) REFRIG 101-500MBTU REFRIG 501-1,000M BTU REFRIG 1,001-1,750MBTU REFRIG +1,750M BTU HEAT PUMP & HEAT -PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & VENTILATING EVAPORATIVE AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER FANS 0-3 TONS _ 3-15 TONS 15-30 TONS 30-50 TONS +50 TONS COOLERS TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE II HOOD CLOTHES DRYER RANGE GAS LOG MISCELLANEOUS (NOT COVERED ELSEWHERE) UNLISTED GAS APPLIANCE <400,000 BTU_ UNLISTED GAS APPLIANCE >400,000 BTU_ USED APPLIANCE <400,000 BTU USED APPLIANCE >400,000 BTU AIR HANDLER <10,000 CFM AIR HANDLER >10,000 CFM 1 1 2 = AMOUNT x$?0.00 = x 25.00 = x 10.00 = x12.00 = x 15.00 = x 1.00 = x 12.00 = x 20.00= x 25.00 = x 35.00 = x 60.00 = x 12.00 = 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 = x 10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = 10.00 12:00 2.00 NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURENJYlikil-tA SUBTOTAL $ 24.00 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE _ $ 49.00 CK #4057 Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675