HomeMy WebLinkAbout1992, 10-19 Permit App: 92009059 Mechanical Fixtureit cm( ,l,VU LAACo°to MECHAN!CAL PERMIT APPLICATION FORM
‘,---1,0-5 12� &kt)( Information Worksheet
JOB STREET ADDRESS: f /i6/s- ma,;i
CITY/STATE/ZIP: O ou4 Q'o2o‘ PARCEL NUMBER:
OWNER: 0 .4h".4)1 PHONE NUMBER: q02 7 -0256 9'
MAILING ADDRESS
(Street)
CONTRACTOR. QCT CCgtf2t/S jetc
MAILING ADDRESS: F /S/r/ r/;€11,
(Street)
(City/State) (Zip)
/�
LICENSE NUMBER: 1CT CCI2' milt/
PHONE NUMBER: 47f' £417
sj.s L /44,499 27
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS EQUIPMENT <100,000BTU (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET).
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 101-500M BTU:T
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,0001-1,750M BTU
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP:8, AIR° CONDITIONER 15-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR CONDITIONER +50 IONS
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE_1(:HOOD
CLOTHES DRYER
RANGE . ..`
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED 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
NUMBER
OF UNITS
X EACH
UNIT
=AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.03 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x25.00 =
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 =
" /
/02 vv
I
SUBTOTAL
$ /„Z O9
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
c
= 5 37 -
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675