Loading...
1993, 06-03 Permit App: 93004254 Mechanical FixturesJOB STREET ADDRESS: JLs MECHANICAL PERMIT APPLICATION FORM 315 Information Worksheet pi -Di L og_ 'ZLUD 3 3 L I Re5b,'e CITY/STATE/ZIP: S IQnk.4c< L,) 9 9 Z©(0 OWNER: •FLL:4 3 Lvov w��zn MAILING ADDRESS. 5 3 .2 1 �J (Street) CONTRACTOR: 4 014 Pk.34/b/4?- L I47 -G. MAILING ADDRESS. E DESCRIPTION :> z K. (Street).. PARCEL NUMBER: PHONE NUMBER' / a y- 97 g0 k444)E L. 4 `3l (City/State) (Zip) LICENSE NUMBER: AZP,qAPN 0q9,�L PHONE NUMBER: 5 3 S - CD -7 ' -7 (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) gromovoitiejfk GAS WATER HEATER x .:v.::$ 8:8:8. .? GAS EQUIPMENT +100.000 BTU DUCTWORK) 7:x;04 BOILER/REFRIG 1-100M BTU BOILER/REFRIG 501-1,000M BTU rAirO.M.7 74-4 BOILER/REFRIG +1 ,750M BTU HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS VENTILATING FANS TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) CLOTHES DRYER GAS LOG 7 z UNLISS_T�ED GAS APPLIANCE <400,000 }}BTU USED APPLIANCE <400,000 BTU AIR HANDLER <10,000 CFM BA S NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE (zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 x 25.00 X 10.00 x12.00 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 x25.00 x 35.00 x 60.00 x10.00 x 10.00 x 50.00 x 10.00 x10.00 x 10.00 x10.00 x 10.00 x 50.00 x100.00 x 50.00 x100.00 x12.00 x 15.00 = = = = = = = = = = = = = = = = = = = = = = = = = = = = = = - - / /0,Oe) / /.2 ,do 4( y,'oo • • '; / /C 656 /o oa } SUBTOTAL $ y6,pc PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =$ 7/J On Sookane County Division of Buildings