1993, 06-16 Permit App: 93004583 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM j 3 - y 6---
Information Worksheet ��
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' JOB STREET ADDRESS: 4716 S. Tipaway
CITY/STATE/ZIP: Spokane, WA 99206 PARCEL NUMBER:Myroa Estates, #6, TAT 8, Bk 4
OWNER: Joseph and T.aurio Palmcluict PHONE NUMBER: 924-4714
MAILING ADDRESS: 4716 S Tipaway Spnkanc WA 99206
(Street) (City/State) (Zip)
CONTRACTOR: River City Sheetmetal LICENSE NUMBER: RIVFIRCS-11011D
PHONE NUMBER: 483-9455
MAILING ADDRESS:
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT = AMOUNT
DUCTWORK SYSTEM •x$10.00 =
WOODSTOVE/INSERT x 25.00 =
GAS WATER HEATER 1 x 10. 00 = 1n on
HEATING EQUIPMENT <100,000 BTU 1 x 12.00 = 17 00
HEATING EQUIPMENT +100,000 BTU x 15.00
GAS PIPING (EA OUTLET) 2 x 1.00 = 2 on
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12. 00 =
REFRIG 101-500M BTU x 20. 00 =
REFRIG 501-1,000M BTU x 25.00 =
REFRIG 1,001-1,750M BTU x35.00 =
REFRIG +1,750M BTU x 60. 00 =
HEAT PUMP & AIR CONDITIONER 0-3 TONS x 12.00 =
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 $ _.24.00
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT
NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE = $ 49.00
SIGNATURE __� Q ,
Spokane County Department of Building_ and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675