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1993, 03-18 Permit App: 93001599 Mechanical FixturesJOB STREET ADDRESS:_ CITY/STATE/ZIP: MECHANICAL PERMIT APPLICATION FORM Irfermation Worksheet 20;_5__/-n `72(jam OWNER: Ma1 r KJ- (p)9. (a - Z®3 -7'). MAILING ADDRESS: CONTRACTOR PARCEL NUMBER: 9Q$ -148- nn /�� PHONE NUMBER: ` 7/ Ca�4 - (Street) ( q g c-/( City/State) (Zip) LICENSE NUMBER: PHONE NUMBER: 41( `4S7o MAILING ADDRESS: 62()0_►- 3� O� (Street) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH OF UNITS UNIT (City/State) (Zip) DESCRIPTION =AMOUNT DUCTWORK SYSTEM WOODSTOVE/INSERT GAS WATER HEATER HEATING EQUIPMENT <100,000 BTU HEATING EQUIPMENT +100,000 BTU GAS PIPING (1 --4 OUTLETS) GAS PIRING (5 OR MORE. EACH:) REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) REFRIG 101-500M BTU REFRIG 501-1,000M BTU REFRIG 1,001-1,750M BTU REFRIG +1,750M BTU HEAT PUMP & 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 HJO D ) 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 X$10.00 = x 25.00 = x 10.00 = x 12.00 = x1,4; _ 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 = /Q.©0 i.2. 00 /•€ 2 NOTE: NIMIIM PERMIT FEE IS $35.00 SIGNATURE r. ! 'vuig kane County Department of Building and Safety • wskrt 1 na Broadway Avenue Spokane, WA 99260 (509) 456-3675 SUBTOTAL $3,00 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE