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1993, 05-17 Permit App: 93003570 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: /1441-itLI. C �LGZG.�1c D CITY/STATE/ZIP: Iktezdet-z"17_ ' 99,a37 PARCEL NUMBER: 4574/ ' X6:17 OWNERS Y w PHONE NUMRURg 9/71s 2/ MAILING ADDRESS: CONTRACTOR: (Strs.t) - (City/Stats) AdeM QUALITY HEATING LICENSE NUMBER: AligumasAvi E. 127iNIANA-AVE. PHONE NUMBER: 24.,2402 SPOKANE; WA 99216 MAILING ADDRESS: (Street) KECHANICAL DESCRIPTION (Zip) (City/Stag) WORKSHEET/PEE SCHSDUL* O UNITS Ktaili DUCTWORK SYSTEM WOODSTOVE/INSERT GAS WATER HEATER HEATING EQUIPMENT <100,000 BTU HEATING EQUIPMENT +100,000 ETU GAS PIPING (EA OUTLET) REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) REFRIG 101-500M BTU REFRIG 501-1,000M BTU REFRIG 1,001-1,750M BTU REFRIG +1,750M BTU HEAT PUMP A HEAT PUMP & HEAT PUMP & HEAT PUMP 4 HEAT PUMP & VENTILATING AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER FANS 0-3 TONS 3-15 TONS 15-30 TONS 30-50 TONS +50 TONS EVAPORATIVE COOLERS TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE II HOOD CLOTHES DRYER RANGE GAS LOG MISCELLANEOUS (NOT COVERED ELSEWHERE) UNLISTED GAS APPLIANCE <400,000 BTU_ UNLISTED GAS APPLIANCE >400,000 BTU USED APPLIANCE <400,000 BTU USED APPLIANCE >400,000 BTU AIR HANDLER <10,000 CFM AIR HANDLER >10,000 CFM (Zip) . AMOUNT •x10.00 - x 25.00 x 10..00 - x 12.00.0 it 2.00.- x 15.00 - x. , 1.00. ,. x 12.00,a x 20.00 0 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 - 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 - x 12.00 - x 15.00 - /, QO /;L,Un NOTE: MINIMUM PERMIT E IS $35.00 SIGNATURE �� Spokane Count Department of Buildin Land Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 SUBTOTAL PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE 5 50,00