1993, 05-26 Permit App: 93003963 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
- 1 �
JOB STREET ADDRESS' a •
CITY/STATEIZJP: -S VIO-(U? , Lop cl,) 0 c' PARCEL NUMBER: 90 LI). ' / D -
PHONE NUMBER:
,i -J,49-3
OWNER: 4...a) (QCi
MAILING ADDRESS:
CONTRACTOR:
MAILING ADDRESS*
DESCRIPTION
(City/State) (Zip)
LICENSE NUMBER: NI) C COtk ! 7()2 U
PHONE NUMBER: ��
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-Trutt. %S
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT.
GAS WATER HEATER
GAS EQUIPMENT 0O,OW :BTU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 501-1,000M BTU
BOILERIREFRIG 1,0001-1,750M RTU
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER O 3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP $1'.AIR.CONDITIONER:15- 30'CONS>
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 .11.800
CLOTHES DRYER
RANGE;
GAS LOG
MISCELLANEOUS Of COVERED ELSEWHE .1
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPIIANCE;!>400 000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE>400,000>STU
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM;:
NOTE: MINIMUM PERMIT FEE IS $35.00
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x25.00=
x 10.00 =
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x25.00 =
x 35.00 =
x 60.00 =
x12.00 =
x20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 1,0.00 =
x 50 o0 =
x100.00 =
x 50.00 =
x100.00 =
x12.00 =
x 15.00 =
/ 6D
i4 CD
,\
, (f?
c9
•
SUBTOTAL
$ Jut- OD
+ $ 25.00
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
FEE DUE
= $ t( L�
o SIGNATURE -16,-,„
1pokane County Division of Buildings
Wes° " ? uu uadway Avenue Spokane. WA 99260 (509)458-1R7S