Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
1993, 04-20 Permit App: 93002673 Inspect
MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: ,-IL-'q et 3- Lrf/1 CITY/STATE/ZIP: e -EK) PARCEL NUMBER: OWNER: PHONE NUMBER: eki-r QAA--e I 062 MAILING ADDRESS: CONTRACTOR: (Street) MAILING ADDRESS: E• 11:13 (City/State) (Zip) LICENSE NUMBER: 12R1 -1e,411 4. /D4, 811) PHONE NUMBER: ail- /*AS DESCRIPTION SPnie.JoAsee 6141 aol (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) X:x§ GAS WATER HEATER ..Yeroo.tive.ww:vei.v ' • GAS EQUIPMENT +100,000 BTU DUCTWORK) BOILER/REFRIG 1-100M BTU laitnikr"d,filattl.C40 . *,,,AMOMMISSI BOILER/REFRIG 501-1,000M BTU atighligIarittrialtalroffittr ivz:vog.W BOILER/REFRIG +1,750M BTU uwegkelfjlifftg0611)) HEAT PUMP & AIR CONDITIONER 3-15 TONS :„T.I.IDVT„1„AlgiOrT 0 kiffp'Y 4-7,452 ;MtAl HEAT PUMP & AIR CONDITIONER 30-50 TONS HET -"TagICSOKKel:79: VENTILATING FANS sr'i7AsMW, S44.50 TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) VAr',•tt( CLOTHES DRYER " : • / GAS LOG .1L§,Xtlgt.tt9AELEPAW:.SagB.g.gag UNLISTED GAS APPLIANCE <400,000 BTU giatiagv.;.,„-GA1411LIANOLCWOMLNIP-1111fir" USED APPLIANCE <400,000 BTU USED IrOaiVi6x Oikti.VW05:"*Nea•:•::' 4 M::::?•igi,:::.&{::+:•04, • AIR HANDLER <10,000 CFM • • • NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x10.00 = x 25.00 = x10.00 = x 12.00 = x 15.00 = x1.00 = x 12.00 = x20.00 = x 25.00 = x35.00 = x 60.00 = x 12.00 = x 20.00 = x25.00 = x 35.00 = x 60.00 = x10.00 = x10.00 = x 50.00 = x10.00 = x10.00 = x10.00 = x10.00 = I )c.; • --)6 x10.00 = x50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = SUBTOTAL $ ).; 013 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE= $ -.7_r i 7 v• /Da& Spokane County Division of Buildings .• I - ,LIZaAret m-- A . n --t %A/ A ncionn ICAO '1 A CA_QA7g