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1992, 01-07 Permit App: 92000001 Mechanical Fixtures
JQB.STREET ADD#1ESS: CITY/STATE/ZIP: s/PARCEL NUMBER: -- 6 /% y OWNER: �r'$12 c PHONE NUMBER: V OU' 074e, f',< MECHANICAL PERMIT APPLICATION FORM InfoWorksheet °I I - ca- 5j ,74is-5 O�y MAILING ADDRESS: 56 V' --e 92 7 5 r' ' '7 /' (Street) %fstf (City/State) CONTRACTOR:4 f (sots SeH�cce j v LICENSE NUMBER: PHONE NUMER: (ZiP) /9f S S.rjate/a X22— 37®y MAILING ADDRESS: (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) (ZIP) is_ 3 1, NUMBER OF UNITS X EACH UNIT = AMOUNT G i NS.S.T:f TL n$f?fiF{F:': U.. „ALA . GAS_ WATER HEATER GAS EQUIPMENT +100,000 BTU DUCTWORK) MET- 4; BOILER/REFRIG 1-100M BTU 0 est BOILER/REFRIG 501-1,000M BTU {1H "fl.;<hx-4� BOILER/REFRIG +1,750M BTU HEAT PUMP. &-AIR CONDITIONER 3-15 TON HEAT PUMP FAIR CONDITIONER 30-50 TONS vENTILAT1IG .Fa TYPE1 x 10.00 = x25.00 = x 10.00 = x 12.00 = x 15.00 = x 1.00 = x 12.00 = x20.00 = x25.00 = x35.00 = x 60.00 = x 12.00= x 20.00 x25.00= x 35.00'== x 60.00418 PER_ 12'OR'12'' •OF HOOD) CLOTHES DRYER GAS LOG UNLISTED GAS APPUANCE <A00,000 BTU USED APPUANCE 6400,000 BTU ept AIR HANDLER <10,000 CFM x x1( x 10.00"=` x 10.00 x10.00= x 10.00 = x 50.00 = X100.00 X 50.00 = X100.00 = x 12.00 = x 15.00 = /2- t 0-00 NOTE MINIMUM PERMIT FEE IS $35.00 SUBTOTAL PLUS: PROCESSING FEE PERMIT DUE EQUALS: TOTAL. FEE $ )3r + $ 25.00 $ 36/ 00 SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675