1993, 01-12 Permit App: 93000147 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: c. 99/6
CITY/STATE/ ://t r COQ.DRE.
OWNER:
MAILING AD S:
Com.
139
PARCEL NUMBER:
C_ L _ PHONE NUMBER: 702 Si' 02/6 9
(Street)
CONTRACTOR. An G A V
MAILING ADDRESS. ?0 1 ` ( /.31/479
(Street)
DESCRIPTION
(City/State) (Zip)
LICENSE NUMBER: NW REF,IQ-/dJ'.T%
PHONE NUMBER: 9aa -402 5
7erAa4v, &)4. 9 9.2/3
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WWOOpSTOVE/INSERT< <.v...
Tr M r.Nma A: OA:'✓:M"'h}'Y:':a.�.).::..:'.n .: .:i••..;'J.
GAS WATER HEATER
GAS;EQUIPMENT'<100,000„BTU (INCLUDES;;;; :;;;:
GAS EQUIPMENT+100,000 BTU DUCTWORK)
:GAS, PIPING .: ::.:....:.:.:..:.:.::.....:.<.:
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG;101.t500M`$TU
BOILER/REFRIG 501-1,000M BTU
BOILERIREFRIG +1,750M BTU
!KAT -PUMP A;AIR,CONDITIONER-0-3TQNS:; ;, . ,
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT.PUMP.;&+AIR CONDITIONER, 15-30+TONS';:;, .
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP AIR CONDITIONER;#50,TONS
VENTILATING FANS
EVAP..OBATIV,E;0,Q9 EfiS:: ;>>:.<:;
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II. HOOD:
CLOTHES DRYER
GAS LOG
;MISCELLANEOUS:(NOTCO.VERED ELSEWHERE.;',:
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS AP);IANCE?400,000:BTU:;
USED APPLIANCE <400,000 BTU
USED:' APPLIANCE,>400,000BTU
AIR HANDLER <10,000 CFM
AIR; HANDLER.,a10,000'CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
2.
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
X 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x1.00 =
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 =
x10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x12.00 =
x 15.00 =
- /
/0.00
/
/5.0O
2.00
SUBTOTAL
$ ,q -at
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 42,00
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675