1992, 10-30 Permit App: 92009568 Mechanical FixturesJOB STREET ADDRESS:
II.J II/
MECHANICAL PERM -FT APPLICATION FORM tt (t04,1t()(
Information Worksheet
40.
/za3 P6,63> A) S ,1
CITY'S-TAT-El/ZIP: , b n%¢ t 4. 9 9 2 ' PARCEL NUMBER: "'MD,./3 . OD(
OWNER: AM OR/VE PHONE NUMBER: 902 - 6 46 9'
MAILING ADDRESS: c:5 -Pin
`E
(Street)
CONTRACTOR: A).w /-/e/7774/6- /4/R6
MAILING ADDRESS:7 BO 1 13 449
DESCRIPTION
(Street)
(City/State) (Zip)
LICENSE NUMBER: /11wR FCid�J�j
PHONE NUMBER:
6k/1Ns /1D4
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
....................................................................................................................
1NO9DSTOVE%INS
GAS WATER HEATER
GAS QUI M NT <100,000ligoopwpES'
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING .(A
BOILER/REFRIG 1-100M BTU
BOILER/REFAIG 101-500M BTU : > ..::
BOILER/REFRIG 501-1,000M BTU
.........................................................................
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HAAT PUMP:.&.AI t.CONDITIONER 15=
HEAT PUMP & AIR CONDITIONER 30-50 TONS
N rION•ER:+
'Ta
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
PEA HOOD ::: :.....
CLOTHES DRYER
RAN.....
GAS LOG
MISCSluNEOUS(NOTC 7VE tED RI,S WHE E
UNLISTED GAS APPLIANCE <400,000 BTU
UL�Ns�r nS Ap ur Nc 400, oo.' ....:. .
USED APPLIANCE <400,000 BTU
USED AFpLIANGE ►OG,000
AIR HANDLER <10,000 CFM
AIR HANDLEI >10, i00 CF.M .........
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE,
99.P/
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
/
x10.00 =
{D•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 =
/02.00
a.O0
x 12.00 =
x 15.00 =
SUBTOTAL
$ .„244:00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ fel-DO
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675