1994, 03-18 Permit App: 94002208 Mechanical Fixtures -. ?,
MECHANICAL PI:=Rt�T APPLICATION FORM • Ilk
information Worksheet
JOB STREET ADDRESS: f, V/5- V 4Al .
CITY/STAT IP:_ rt, IC y9,3/�o PARCEL NUMBER:
ppa�"l'y'l"--` PHONE NUMBER: .6 - 3
MAILING ADDRESS:_
(Street)�¢ (City/State) �1 (Z114CONTRACTOR: IV f-r-re) //��t-.1-t LICENSE NUMBER:I0 OP C Q 1//T C 7 6 L I
PHONE NUMBER
MAILING ADDRESS: ,t------ 5 f D Z -7, ,1i,, 2� C e)(t' . 4 /01._
(Street) / (City/State) / (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH 1
DESCRIPTION OF UNITS UNIT = AMOUNT I
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 =
W000SSTOVE/INEEiRT.,. .. . x 25.00 =
GAS WATER HEATER j x 10.00 = . /n, 0 0
GAS EQUIPMENT 00:0 BTU(INCLUDES I x 12.00 = ._._L a 0
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
GAS PIPING.(EA OUT E. Milli ...... ......... x 1.00 = „71.06
BOILER/REFRIG 1-100M BTU x 12.00 =
. ..::::.::::.
<E U EW EE G 1 1; 0I M BTU ........: x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
BOII;stREgP1GI O01-t750M BTU ' x 35.00 =
BOILER/REFRIG +1,750M BTU x 60.00 =
HEAT PUMP IRC DITION ER 0.3 TONS. .... ; x 12.00 =
HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 =
HEAT:P M P :AIR CONDITIONER 15-3 T«I,tS x 25.00 =
HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 =
NEAT PUMP AIB CONDITIONER +50 TONS .. ..I. , x 60.00 =
VENTILATING FANS x 10.00 =
EVAPO ATIVE.C+E LEBS::: .:... x 10.00 =
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
x 10.00 =
CLOTHES DRYER x 10.00 =
RANG ......
x1000
GAS LOG x 10.00 =
MISCELtAWEOCIS(NOT COVERED ELSEWHERE x 1,0.00 = �-
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINSTEI}GAS A.. PL.IAN E>400,000 BTt.1. x100.00 =
USED APPLIANCE<400,000 BTU x 50.00 =
USED APPLIA1NCE>400,000;BTU x100.00=
AIR HANDLER<10,000 CFM -- x 12.00 =
AIR HANDLER1.0,000 CFMC x 15.00 =
SUBTOTAL $ j4/. Q 0
PLUS: PROCESSING FEE + $ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE =$ l'/ O 0
SIGNATURE -"e6-,_ .A 7)-A!±,--
Spokane
- `±Spokane County Division of Buildings
West 1303 Br,, l" Avenue Spokane, WA 99260 (509) 456-3675