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1993, 02-22 Permit App: 93000997
1.15022 . X012 cloi) o r�c.G� I ,.CHANICAL PERMIT APPLICATICt :FORM �� "1�eM7 � wk,_1 / 7 0 ao Information Worksheet JOB STREET ADDRESS: lei-4':' . i?(_C-`l 3 2 v CITY/STATE/ZIP: 'i�) . ( ,L) Cl a I(Q PARCEL NUMBER: OWNER: 'r)( ChCl C t GL - PHONE NUMBER: CI c-1- q MAILING ADDRESS: 1� (Street) (City/State) (Zip) CONTRACTOR: I� (,)(C1 C LICENSE NUMBER:LCOtinf 70 Rj? PHONE NUMBER: .(`(.(ci MAILING ADDRESS: 6 1 D3 7&xil- 9(??/7_ (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT = AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = WOODSTOVEIINBE T ::: x 25.00 = GAS WATER HEATER x 10.00 = GAS EQUIPMENT<100,000 BTU (INCLUDES . '_-- .3 x 12.00 = J, . (J7' GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = G.AS•PIPING (EA OI)TLET) :: .. .:::..:... . :::.. .. .. : -� x 1.00 = BOILER/REFRIG 1-100M BTU x 12.00 = / BOILERIREFRIG 101 -SOON BTU x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = BOILER/REFR,IG 1,0001 1750M BTU x 35.00 = BOILER/REFRIG +1,750M BTU x 60.00 = Hps.r PUMP &AIR CONDITIONER 0 3 TONS x 12.00 = HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 = HEAT PUMP&.;AIR CONDITIONER 15 30 TONS x 25.00 = HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 = HEAT.PUMP &AIR CONDITIONER +50 TONS x 60.00 = VENTILATING FANS x 10.00 = EVAPORATIVE COOLERS x 10.00 = TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = TYPE U HOOD : . : x10.00 = CLOTHES DRYER x 10.00 = RANGE ; xla.00 = GAS LOG x 10.00 = MISCELLANEOUS(NOT COVERED ELSEWHERE x10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = UI.INSTED GAS APPLIANCE>400,000 BTU : , x100.00 = USED APPLIANCE<400,000 BTU x 50.00 = USED APPLIANCE>400,000 BTU`' x100.00 = AIR HANDLER <10,000 CFM x 12.00 = AIR HANDLER>10,000 CFM x 15.00 = SUBTOTAL $ /,3, PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE = $ N3 9 e SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675