1993, 03-18 Permit App: 93001595 Mechanical FixturesMECHANICAL PERMITAPPLICATION FORM
Information Worksheet/
JOB STREET ADDRESS: ..5-7/"/ln /J'( /27 e /)cV7 '/e AOII/
CITY/STATE/ZIP:5ROkali P 404 99 PARCEL NUMBER:
OWNER: i1i [OM k. PHONE NUMBER: 9;74-7 I
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: Heat Transfer Inc. UCENSENUMBER: Heatti-1881n
PHONE NUMBER: 482-2000
MAILING ADDRESS: N. 3003 Crestline Spokane, WA 99207
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOOQSTOVE/INSERT
GAS WATER HEATER
GAS; EOUIPtr1ENT:. 10O,000.ETJJ.(INearl IDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
A.OUTLE T
EOILER/REFRIG 1-100M BTU
801LEA{AEFAtG bV-560-iia i1;.w
BOILER/REFRIG 501-1,000M BTU
BOILERIREFRIG`]_Ooo:t 4,750M;:BTU:
(zip)
NUMBER
OF UNITS
X EACH
UNIT
=AMOUNT
BOILER/REFRIG +1,750M BTU
HEAT.PUMP.y& AIR:: CONDITIONER_0-3°TONS :
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP &AIR CONDITIONER 15_-30 TONS;A ;:x_
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP:&:AIR.CONDITIONER:+50TONSr::u:r::
VENTILATING FANS
:EVAPORATIVE .COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE(' HOOD: r:iL<..::.:..�:::::'`;.::z;::'=::;c..:':::::',i,.::.i::':;
CLOTHES DRYER
GAS LOG
'MISCELLANEOUS(NOT"COVERED ThkWHERI
UNUSTED GAS APPLIANCE <400,000 BTU
ULINSTED'.GASAPPLIANCE.?400,0008TU,:;..;<_`':;„=:;
USED APPLIANCE <400,000 BTU
USEO:APPLIANCE?40&00b E
AIR HANDLER <10,000 CFM
'ALR HANDLER:>>10,000:CP A
NOTE: MINIMUM PERMIT FEE IS $35.00
x 10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x1.00 =
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 3 ,
x100.00
x 12.00 =
x 15.00 =
SUBTOTAL
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
FEE DUE
/0, 00.
/a,.6D
no
+ $ 25.00
=$ Too
SIGNATUREIta/141,-1.4
Spokane County Division of Buildings MAR I $ IS
West 1026 Broadway Avenue Spokane, WA 99260 (509) 456-3675
Co