1990, 11-20 Permit App: 90006305 Mechanical FixturesMECHANICAL, PERMIT APPLICATION FORM I- -3
Information Worksheet 9p ._ C365 --
JOB STREET ADDRESS: / 86 ca 0°cl Q9 -y, /v.a3- / /9 '7
CITY/STATE/ZIP:., {pg,7 Gt Ph .aa ./W4 991,PARCEL NUMBER: 7/w//rs (//P4/ AI6I6 .
OWNER: 100 ge. d )t,r A n a
MAILING ADDRESS: / $(o O a
(Street)
CONTRACTOR: y Cn h,2/ )&t-&io->-k
MAILING ADDRESS:
PHONE NUMBER: 9027-427471
P 3707
(Street)
(City/State) (Zip)
LICENSE NUMBER:SS-/718-S/2- 3 73_/07-
PHONE
3_/0flPHONE NUMBER: cf Sgq '/l7O X 3c/C,
% R,/ &tet, 4L9 992a0
t(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
OF UNITS
DESCRIPTION
X EACH
UNIT
= AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIING (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
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
VENTILATING FANS
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD"
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 =
x 15 4";11;04•-
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
/ °b
/•oo
NOTE: IN MUM(- IT FEE IS $35.00
SIGNATURE K.L7VtakL2E oaai9QQ
Spokane Couty Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
SUBTOTAL
$ /3 'OQ
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE