1993, 09-13 Permit App: 93008231 Mechanical FixturesMECHAMCAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS' / 0 0 1I H M..r n+i .irr1
93- Sz3-1
CITY/STATEJZIP: S ✓] 0..,, 0 ./ [Ala 5740 G PARCEL NUMBER:
PHONE NUMBER: q„) % - g[. n
MAILING ADDRESS:
4' ' / (Street) .% , (City/State) (Zip)
CONTRACTOR: /V r --r { F/ -?.n t ° LICENSE NUMBER: /\)O PC!) N A 07 f L I
PHONE NUMBER: 5:g -V- N 9 15
MAILING ADDRESS: '
vl
DESCRIPTION
99yig
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOO,DSTOVE/INSEKi7 `
vGAS WATER HEATER
G;AS EQUIPMENT .000,000 DTU (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS;P,IPING. EA_OUTL..,
BOILER/REFRIG 1-100M BTU
iBOILER/REFRIG101500M: BTU:
BOILER/REFRIG 501-1,000M BTU
;BOILER(REFRIG:1,0001-1,750M
BOILER/REFRIG +1,750M BTU
.HEAT;PUMP:&.AIR :CONDITIONER,0-3:TONS'.:
HEAT PUMP & AIR CONDITIONER.3-15 TONS.
:HEAT PUMP & AIR,QONDITIONER,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 HOOD)
CLOTHES DRYER
RANGE
GAS LOG
:MISCELLANEOUS(NOT COVERED, ELSEWHERE ,`.:.';
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS: APPLIANCE>400,000:BTU':_:
USED APPLIANCE <400,000 BTU
USED APPLIANCE,>400,000 STU
AIR HANDLER <10,000 CFM,
AIR 'HANDLER>10,000 CFM
NOTE:I-MINIMUM PERMIT FEE IS $35.00
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x10.00=
x12.00=
x 15.00 =
x 1.00 =
x 12.00 =
x20.00 =
x 25.00 =
x 35.00 =
(x60.00 =•
'x-12.00 =- -
x20.00-=
x 25.00 =
x 35.00 =
x60.00=
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x10.00 =
x 50.10 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/
10.00
/,9•nn
()0
..- _ .-_
' -: , .,
-
_
SUBTOTAL_ ._ .
$H.o 6
PLUS: PROCESSING FEE _.
-+$ •-25.00•
EQUALS* TOTAL PERMIT,
FEE DUE.:.. .
= $ ' 9.,i7 --
SIGNATURE
Spokane County Division of Buildings
West 1303 ` way Avenue Spokane, WA 99260 (509) 456-3675
re N A 01 (o14
r DETACH 70 DISPLAY CERTIFCATE —1
......... . • -
It .
THIS CERTIFIES THAT THE PERSON NAMED HEREON IS REGISTERED AS PROVIDED BY LAW AS A
DEPARTMENT OF LABOR AND INDUSTRIES
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..7- -, PEGISTRAMON N'ARBER ElPlitAlW Off ' P
PI
Etn • N...12-C.:Ht.c./ 761-1 06 /21/95!
1 STATE Of WASHINGTON
1
;114000 HEAliN-S AU: CC'-) INC
W5103- E TRE!,7 ti
91 SPOKANE • JA 5' ;2I21351
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OUCH TO DISFtAv C9111FICAT!
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