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1991, 11-25 Permit App: 91008160 Mechanical FixturesMECHOCAL PERMIT APPLICATION FOO Information Worksheet PARCEL NUMBER JOB STREET ADDRESS: CITY/STATE/ZIP: 2. ,i / 4 1- PHONE NUMBER: (Street) (City/State) OWNER: MAILING ADDRESS: (Zip) CONTRACTOR: L, •)(/9--Ict Cr) ` 5 LICENSE NUMBER: DO- //AZ° /7 75 /Z PHONE NUMBER: MAILING ADDRESS: / /7.77 _ /9.C/CA'/G(L/I41 5(t��t �/ 2 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) ..................... ..................... WOQDSTOVE/INSERT GAS WATER HEATER GAS EQUIPMENT;<100,000 BTU (INCLUDES GAS EQUIPMENT +100,000 BTU DUCTWORK) GAS PIPING (EA OUTLET) BOILER/REFRIG 1-100M BTU ....................................................................... BOILR/REFRIG 101-500M• BTU BOILER/REFRIG 501-1,000M BTU ................................................................................. ................ BQ)La*R/REFRIG.1,0001 1,750M BTU BOILER/REFRIG +1,750M BTU ....................................................................................................................... ;HAIRCO. NDITIONER 0.3 TONS HEAT PUMP & AIR CONDITIONER 3-15 TONS .................................................... ...................................................................................................................... 'HEAT>PUM.P: & MR::CONDITIONER 15-30'TONS' HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMP: & AIR`.. CONDITIONER,+50 TONS ............................................................................................................. . VENTILATING FANS EVAPORATIVE CO,OLERS..... TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) CLOTHES DRYER .............................................. ............................................... RANGE GAS LOG .......................................................... MISCELLANEOUS (NOT COVERED ELSEWHERE UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED 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 NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATU�R2�/l�� Spokan County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x 1.00 = x 12.00 = x20.00 = x 25.00 = x35.00 = x 60.00 = x 12.00 = x20.00 = x25.00 = x 35.00 = x 60.00 = x 10.00 = 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 = SUBTOTAL $ PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $