1992, 12-22 Permit App: 92011125 Mechanical FixturesMECHANICAL PERMIT,APPLICATION FORM
��� j Information W�ojrks/heett r �/j
JOB STREET ADDRESS: IICTF // Y#(6,YSC C� T /C� C 1'�liSsfOVI
CITY/STATE/ZIP: ja00,r�rn e ✓ ,4. 9c en PARCEL NUMBER' 5e.5/A/• o G / 7
OWNER: Alafr //1L>Kie_ PHONE NUMBER: a- v- ;G_
MAILING ADDRESS: vlffa
(Street) (City/State) (Zip)
CONTRACTOR: YD?%e/ 5 CU. LICENSE NUMBER: 5 i*/ /TN $C 09 90 A-
/ %J PHONE NUMBER:
MAILING ADDRESS: !T/• `4;//0T�Y476/.56, &/ 3 czk .
(Street) (City/ tate)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT ,
GAS WATER HEATER
GAS EQUIPMENT <100;0,00BTU. (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPIING.(EA:OUTLET):.::'.:::F:< `::r<;I < €;: ;
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 101�5.00M_BTU
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:&Alp'CONDITIONER:IS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT'PUMP'&'*.CONDITIONER +50:TONS::
VENTILATING FANS
EVAPORATIVE:;COOLERS [.;a.:
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
:'• : �7 ''• :•:
CLOTHES DRYER
RANGE:`'.:':::'" ;re.
GAS LOG
'MISCELLANEOUS (NOTCOVERED ELSEWHERE:;1/4:
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GASAPPLIANCE=>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
%-ZitZ
992704/
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
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 =
---nt
2
I
x 15.00 =
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
/�
_ 7 $ 2--°11/
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675