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1992, 09-17 Permit App: 92007777 Mechanical Fixtures 7-17 MECHANICAL PERMIT APPLICATION FORM c:;\ a` + InformationWorksheet -7 97 JOB STREET ADDRESS: E /'2ã/ f r5pr 14, .7 A'-e /d CITY/STATE/ZIP: st,,-c W or. 99412 o 4. PARCEL NUMBER: X1.5"/ 4.1. O /G 1/ OWNER: 4(.) In 1,1,1 Lt4 CSi77i- -• PHONE NUMBER: 9 2- �- V9 L/7 MAILING ADDRESS:I /f /U?/e/ 5/21 ,'i f r'-c./l (Street) / (City/State) (Zip) CONTRACTOR: LICENSE NUMBER: PHONE NUMBER: MAILING ADDRESS: (Street) (City/State) - (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = WOQDSTOVE/iNSERT x 25.00 = ................::.........:..::.....:....:............... ........... ..............................................:................ GAS WATER HEATER 1 x 10.00 = /0, o 0 GAS EQUIPMENT«00,000 ETU(INCLUDES / x 12.00 = /2 . o o GAS EQUIPMENT+100,000 BTU DUCTWORK) x15.00 = GAS.PIPING (EA>QUTLET) �.>: ::: :.: ..::; : :;;:::;;:::;::>;>::; :::;:: :': x 1.00 BOILER/REFRIG 1-100M BTU x 12.00 = BOILER/FiEFRIG 101 SOOM BTU x 20.00 = . BOILER/REFRIG 501-1,000M BTU x 25.00 = BOILER/REF'RIG 1,0001 1,750M BTU '; x 35.00 = BOILER/REFRIG +1,750M BTU x 60.00 = MEA PUMP&A R CONDI t TONER 0-3 TONS. x 12.00 = .....:....:::.....::............................:.............:........................:...............::.::.............................::. HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 = ........................................................................................................................................ HEAT PUMP&ACR CONDITIONER 15 3O TONS ``:< . : x 25.00 = HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 = HEAT`PUMP&AIR CONDITIONER+50 TONS x 60.00 = VENTILATING FANS:::::.::............................ ............................................ . x 10.00 = ............................................................................:•. EVAPORATIVE COOLERS . <::< ::> :: x 10.00 = TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = ........................................................................................................................................... ............................................................................................................................................ TYP.::E.II HOOD.: x 10.00 = CLOTHES DRYER ::::..................... ................... ....._._..............._........ x 10.00 = ......................................................................:............... ........................................................................................................................................... RAN:GE.....:. x 10.00 = LOG:::::::......_......_............_ ...._._.._ ..... .. .....__..._....._.............. x 10.00 = ........„...„:.......................................................................................... GAS ........................................................................................................................................... .................................................................................................................................. ..... MISCELLANEOUS(NOT;COVERED ELSEWHERE;: ; x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ULINSTED GAS APPLIANCE.>400,000 BTU; x100.00 = .........:.:....... ...:....-...-.................:............. USED APPLIANCE<400,000 BTU x 50.00 = USED APPLIANCE>400,000 BTU :: : : x100.00 = AIR HANDLER<10,000 CFM x 12.00 = AIR:HANDLER.>10,000 CFM x 15.00 = SUBTOTAL $ 22, c J PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE =$ L/7 %'! SIGNATURE 7 --74/1 Ist----.....4".....) Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675