Loading...
1991, 09-17 Permit App: 91005914 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM y 7 Information Worksheet JOB STREET ADDRESS: 3. u ll/i/a CITY/STATE/ZIP: //e;ra'a6/e/ PARCEL NUMBER: OWNER: h .y 4r z...-6Q c I/h PHONE NUMBER: MAILING ADDRESS: 14i J1 ` (Street) (City/State) (Zip) CONTRACTOR:,Swtlfh gro7L llerS LICENSE NUMBER: 3 )11 ( rH BGoggO,4 PHONE NUMBER: `Pig 978?' MAILING ADDRESS: k. 411.0 gre.to i € of S�oA��e 44. 1-1120 S1 (Street) - (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = x 25.00 = GAS WATER HEATER x 10.00 = GAS PMI.'I T<1 0, ITU(INCLUI ES x 12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = �GA�.' :>:I:;;»>.:.,:. ::E:`.::>::>U E , >`= >' < € >' > <> '» »<< ;; > > .�`:.:.::;��..>�:: ......a. � T ::>:;:>:<.;;::.:::::; x 1.00 = BOILER/REFRIG 1-100M.BTU x 12.00 = x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = x 35.00 = BOILER/REFRIG +1,750M BTU x 60.00 = :..EA'1`PUMP 8 AIR CONDITION ER 0-3 TONS x 12.00 = HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = HEA:::.>:..:::.>:: _,..:::: ::::::;�::.:::.::::::..;::: > .:: ;::-:.::::: .: .:, ;..: :.:.<;<>»»<�� ���` > :HEAT PUMP AkI 2 DIT NER 1 Sg T©N >- :. ::;::: x 25.00 = HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 = . A:_, PUMP&AIR C DITION ER+50 TONS ;.:;;: x 60.00 = VENTILATING FANS x 10.00 = x 10.00 = TYPE I HOOD(PER 12' OR 12' PTN. OF HOOD) x 50.00 = ...;::.;::.;�II#� D....... :. :.:>::»::>... . ..... :.:... .. ........ x 10.00 = CLOTHES DRYER x 10.00 = <.;:;:.:.;;: 1=......... ..... .... ......... x 10.00 =- GAS GAS LOG x 10.00 = MISCELLANEOUS(NOT OVERED:ELSEWHERE :;::,:>;:' x 10.00 =- UNLISTED UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ULINSTED 1S APPLIANCE>400,t ..... : '' x100.00= USED APPLIANCE<400,000 BTU x 50.00 = x100.00= AIR HANDLER<10,000 CFM x 12.00 = AIR IANDLER ,000 AI=M =.. x 15.00 = SUBTOTAL $ PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 • EQUALS: TOTAL PERMIT FEE DUE _$ SIGNATUF --2:-11~,.�.� Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675