Loading...
1992, 08-20 Permit App: 92006664 Mechanical FixturesJ MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: % -4 . ...(1i,4 d CITY/STATE/ZIP: CcJr� PARCEL NUMBER: OWNER: 0 SO -"....,r3, PHONE NUMBER: (7o. `r` - 2_3d MAILING ADDRESS: CONTRACTOR: ‘t.)yetit� L MAILING ADDRESS: P el, %J V02 (Street) (Street) DESCRIPTION (City/State) (Zip) LICENSE NUMBER: G.,/%9 771/C -/e1 / G*i PHONE NUMBER: 53S- F 4/ .? 7 072.4) 9R2// (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) w. v GAS WATER HEATER EQUIPMENT <100 00 BTU (INCLUDES ..... GAS EQUIPMENT +100,000 BTU DUCTWORK) PIPIN E.:< BOILER/REFRIG 1-100M BTU :BOILER/REFRIG 1IO1 .500M.BTIJ• > ::: < >_ > « > BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG 1! 00ol .1,750M I BOILER/REFRIG +1,750M BTU HEAT PUMP & AIR CONDITIONER 0; 3 TONS.::;::: HEAT PUMP & AIR CONDITIONER 3-15 TONS ligkrippm-RAAR:ioplpyrtpopli15.50 TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS :HEAT BUMP & AIR CONDITIONER +5TO• NS VENTILATING FANS V/APORATIVECOOLE TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYpE.I. L.N. ;. CLOTHES DRYER GASLOG:::.::........................................................................................... MISCELLANEOUS (NOT COVERED ELSEWHEF E UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED GAS APPLIANCE>1O0,0of1 BTU..... USED APPLIANCE <400,000 BTU .............................:::::::..:.:::::::. AIR HANDLER <10,000 CFM AIR HANDLER >10,000 OFM NOTE: MINIMUM PERMIT FEE IS $35.00 NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = / x10.00 = ,0 -- x 12.00 = / x15.00= / -- 1/- x1.00 = rk x 12.00 = x 20.00 = x 25.00 = x35.00 = 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 = SUBTOTAL $ a`'\ PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ 54k SIGNATURE y.c , tac Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675