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1992, 01-31 Permit App: 92000556 Mechanical Fixtures,n,�1/4RoN ESTE'"MECHANICAL PERMIT APPLICATION FORM Information Worksheet F.:, L-24 a a STREET„ADDRESS: ,•.. Y/STATE/ZIP: a23 L& -)d oA,trozk WNBRe tI1 f �' ILING ADDRESS: cl�-s5� Icog Z.B( PARCEL NUMBER: PHONE NUMBER: i (¢ity/State))(Zip) LICENSE NUMBER: KTUSp�1:41y�, 3M4 Lk& 7 `ios % PHONE NUMBER: ILING ADDRESS: E. !0C1\114+0-22.4...../ (Street) (City/State) MECHANICAL WORKSHEET/FEE„SCHEDULE NUMBER OFJUNITS DESCRIPTION X EACH UNIT DUCTWORK SYSTEM • WOODSTOVE/INSERT GAS. WATERHEATER HEATING EQUIPMENT <100,000 BTU HEATING EQUIPMENT +100;000 BTU GAS PIPING (EA OUTLET) • REFRIG;1-100M BTU (NOT A/C OR HEAT PUMP) FRIG.101-500M BTU FRIG 501-1,000M BTU-' EFRIG:1;001-1,750M BTU FRIG+1,750M,BTU.:'- EAT'PUMP ''&' EAT:PUMP :: & ' SHEAT PUMP.::,& HEAT'PUMP- &' uHEAT, PUMP•.:& VENTILATING AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER -AIR CONDITIONER 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) STYPE II HOOD CLOTHES DRYER AFS LOG_ ' ISCELLANEOUS:.(NOT ''COVERED ELSEWHERE) 1,(L•ISTED GAS. APPLIANCEM<400, 000 BTU UNLISTED GAS `APPLIANCET>400,000 BTU SED,APPLIANCE`:<400,000BTU SED APPLIANCE >400,000 BTU AIR -HANDLER <10,000 CFM AIR HANDLER >10,000 CFM NOTE: �MINSMnUM PERMIT FEE IS /$/35.00 SIGNATURE c>X 01CL- 6 -060-,71Px2�p - ' Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 1 SUBTOTAL PLUS:' PROC (Zip) = 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 = x 15.00 = ESSING FEE $ 13,00 + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE $ 00 •