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1992, 09-17 Permit App: 92007758 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: S E. n\ ,i_Wl c CIT USTATE/ZIP:Oki k�' CI' PARCEL NUMBER* OWNER: RC. W0.h1 PHONE NUMBER: L MAILING ADDRESS* 1L110-1 01\im()1C. J • (Street) (City/State) (Zip) • CONTRACTOR: AetU 0. lil(9-.CAUv„‘\ Com\ LICENSE NUMBER: A - G., IN VV\ A -CZ lao Q Cy— PHONE NUMBER: ygi - 0 \ 03 MAILING ADDRESS: (Q(10 DESCRIPTION �i U c-1 cc ,• )cam WA- 9 (Street) • 1(City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER OF UNITS X.EACH • • UNIT = AMOUNT ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) GAS WATER HEATER GAS EQUIPMENT +100,000 BTU DUCTWORK . BOILER/REFRIG1-100M BTU r.K V:.Mvv gfiai,/� BOILER/REFRIG 501-1,000MaTU v^• �;w`7 ��� Ebb `� A 4 Bis^ t�-�<�n`� �'�' BOILER/REFRIG +1.750M BTU HEAT PUMP &AIR CONDITIONER.3-15 TONS HEAT PUMP. & AIR CONDITIONER 30-50 TON Af VENTILATING FANS TYPE I HOOD (PER 12''OR:12';jam. 'OP•HOOD CLOTHES DRYER GAS LOG UNLISTED GAS APPUANCE <400,000 BTU AIR HANDLER <10,000 CFM AAAA x .10.00 = X 25.00 = x 10.00 = x 1.2.00 = .:x,15.00 _ 'x -1.00 ' _: ,x:12.00 = x 20.00;:= x•25.00 =. X 35.00 `• _ x'60.00 ` _. x12.00 _ x.20.00 = •. x2540 = X35000� '= x: 60.00 x10.00 = X10.00 :x50.00 = x10.00 ` _ x.10.00 x 10:00 =: x 10.00 =• x1.0.00`= •: x 50.00 _ x100.00 = x50.00 = x100.00 = x 12.00 •= x15.00 _:. • NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE (T LQ%'X 44— SUBTOTAL PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE Spokane County Division of Buildings West 13f1R Rrnadwav Avarua Snnkanp WA QQ9Rf1 (R(141 dcR_'R7t fec 4