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1992, 07-23 Permit App: 92005642 Mechanical FixturesLA5 . 01'05 \/ Z-ts g. ►-15 MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: q as -L214 acv -(3 CITY/STATE/ZIP: e-Ix^,Vajkle, W PARCEL NUMBER: OWNER:0„.a.11 6tM4 d PHONE NUMBER: ,pliZWe, \JA (Street) ( ity/State) (Zip) MAILING ADDRESS: Fl/k21( hd CONTRACTOR: Ron) nkoaa 5 LICENSE NUMBER: '1'�n) Wap .1Of31JT PHONE NUMBER: 3:25-164o MAILING ADDRESS: S. � I" ���(()IG . �( �Q _ WA (Street) ) (City/State) MECHANICAL; WORKSHEET/FEE; 'SCHEDULE . NUMBER X EACH DESCRIPTION OF::UNITS UTNIT DUCTWORR','SYSTEM WOODSTOVE/INSERT GAS; WATER{HEATER _ _ _ _ •HEATINGEQUIPMENT-<100.,000 BTU TING EQUIPMENT,;+100,000 BTU P„PIP,ING' (EA OUTLET) RIG 1.0010 , (NOT A/C OR HEAT ! PUMP. ---,:1O1-500M BTU _ 1- i,loQOM -B1' 750M' B TU _ _ CONDITIONER - 0 3 :;:.TONS. x. z. .CONDITIONER 3-15 TONS &p AIR; CONDITIONER:e15 .30 '.TONS SAT, PU&F AIR''CONDITIONER 30750 . TONS •_ HEAT yPUMP,&, AIR'S CONDITIONER +50: TONS _ VENTILATING; ":FANS EVAPORATIVE COOLERS _ TYPE t -H OOD (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 U.GU. r x$T0.00 = x 25.00 '= x'10:00 x 12 "' x01;15 .. xr,20.� x4250 )c14.35:.0 x; 60.00 x12:+ XZ'2031 x"•2 x60...00 X' 10.00i= 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 = (Zip) . 10, on NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE SUBTOTAL PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ Spokane County Department of Buildingand Safety West 1303 Broadway Avenue Spokane, WA 260 (509) 456-3675