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1992, 11-05 Permit App: 92009803 Mechanical Fixtures up„ .z. 0 Vo\ MECIIANICAL PERMIT APPLICATION FORM 92___ t,,o3 /�‘je.rA.c.Y�R VA I ib-f Information Worksheet JOB STREET ADDRESS: -S-1 . 116 6 /� z6"� 6 O -�/- 9 CITY/STATE/ZIP: ll€ A6- DALE `,J 97( '7PARCEL NUMBER: z OWNER: PL-C-.-(r- goL --r .7--, 6_-_ .- PHONE NUMBER: C7c2C 1> ;- c MAILING ADDRESS: /4 /7-''6 (Street) (City/State) (Zip) CONTRACTOR: MARTIN SHEET METAL Inc. LICENSE NUMBER: MARTISM170KW PHONE NUMBER: 924-8088 MAILING ADDRESS: BLDG. #103 SPOKANE INDUSTRIAL PARK SPOKANE, WASHINGTON 99216 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT = AMOUNT ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) _ _ x$10. 00 = WOODSTOVE/INSERT x 25. 00 = GAS WATER HEATER / x 10. 00 = / 0(c)0 GAS EQUIPMENT <1000, 000 BTU_ (INCLUDES _ / x 12 . 00 = /-1-1)(-1 GAS EQUIPMENT +1000, 000 BTU_ _DUCTWORK)_ x 15. 00 = GAS PIPING (EA OUTLET) x 1. 00 = a,2. e%o BOILER/REFRIG 1-100M BTU x 12 . 00 = BOILER/REFRIG 101-500M BTU x 20. 00 = BOILER/REFRIG 501-1, 000M BTU x 25. 00 = BOILER/REFRIG 1, 001-1, 750M BTU x 35. 00 = BOILER/REFRIG +1, 750M BTU x 60. 00 = HEAT PUMP & AIR CONDITIONER 0-3 TONS _ _ f x 12 . 00 = /4410 HEAT PUMP & AIR CONDITIONER 3-15 TONS _ x 20. 00 = HEAT PUMP & AIR CONDITIONER 15-30 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 = TYPE II HOOD x 10. 00 = CLOTHES DRYER x 10. 00 = RANGE x 10. 00 = GAS LOG x 10. 00 = MISCELLANEOUS (NOT COVERED ELSEWHERE)_ _ x 10. 00 = UNLISTED GAS APPLIANCE <400, 000 BTU_ _ _ x 50. 00 = UNLISTED 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 $ 3 &c,e PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMITA NOTE: MI IM M PERMIT F I $35. 00 FEE DUE = $ 61 LzL) SIGNATURE vU � (3 , 1��� �'' Spokane County Department of Buildings 'Vest 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675