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1993, 01-14 Permit App: 93000203 Mechanical Fixtures
MECHANICAL PERMIT APPLICATION FORM 9 Information Worksheet JOB STREET ADDRESS: <690// 74.) 203 CITY/STATE/ZIP: Sint) kia ••••- -e- 4/o. 4 PARCEL NUMBER: OWNER: Sr -e v -e-- d 6 14-,A.L.! PHONE NUMBER: ? 2e-&82.2_ MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: D--e-s .1.3 ki) ...c4 4 -e -t -M -e-47 LICENSE NUMBER: ,T)-eSO-S/? 0 PHONE NUMBER: MAILING ADDRESS: £ ivIce 7,74 //400‘, .-3.1,4:314401-•-e- e.A,e, j II. 1-7 ? 2 0 2 - (Street) (City/State) (Zip) MECHANICAL WORK DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) GAS WATER HEATER AS.EQU1PME1.I 00,0001 GAS EQUIPMENT +100,000 BTU DUCTWORK) • • BOILER/REFRIG 1-100M BTU . . HEAT PUMP & AIR CONDITIONER 3-15 TONS HEA•- ................... ...„ HEAT PUMP & AIR CONDITIONER 30-50 TONS 4ER +50 TONS VENTILATING FANS . _ TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) CLOTHES DRYER GAS LOG • • • • " • •"." • " • • • • • • UNLISTED GAS APPLIANCE <400,000 BTU USED APPLIANCE <400,000 BTU APPLIANCEUSED - AIR HANDLER <10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x10.00 = x 12.00 = x 15.00 = x1.00 = 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 = x10.00 = x10.00 = x 50.00 = x10.00 = x10.00 = x10.00 = x10.00 = x10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = J I• - it -=fr 4a. . x 12.00 = x 15.00 = SUBTOTAL $ .1.1°' PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =$ `/'-- Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675