1994, 08-31 Permit App: 94008479 Mechanical Fixtures59D1 is -2
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MECHANICAL PEMIT APPLICATION FORM
Information Worksheet
J` :LtTREET ADDRESS: / . / 83 / S R ()QV( CO
•
CITY/STATE/ZIP: -Sp 0Kc-tnt ILL \ G C101to PARCEL NUMBER:
OWNER: 5-4 CL) KvGS YY\, s h & PHONE NUMBER: Ci �,s' - Cv(S •C!
MAILING ADDRESS: Scam -e_
Q4 git-ig
(Street)
CONTRACTOR: LC N,,)a't-l'tS -eGAY\
MAILING ADDRESS: PLJ r 60 X k I (a,
(Street)
DESCRIPTION
(City/State) (Zip)
LICENSE NUMBER: W O L/ TT NC K> 1 C
PHONE NUMBER: -535
(City/State) - (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
........................................................................................................................
11 VOODSTOVE/INSER1
GAS WATER HEATER
GAS, EQUIPMENT<100,000.BTU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
...............................................................................
GAS PIPING (EA OUTLE <<
BOILER/REFRIG 1-100M BTU
......................................................................................
BOILER/REFRIG 101 500M BTU <•
BOILER/REFRIG 501-1,000M BTU
<BOILER/REt IVIG a,A001-1,750MB
BOILER/REFRIG +1 ,750M BTU
HEA i PUMP AIR CONDITIONER t TQNS ?.
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUM & AIH:Ut. NUI I IONER.15'-:30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
:HEAT PUMP & AIR GCJ►IVI 11 IC:NEn +50 T•ON•S
VENTILATING FANS
EVAPORATIVE COOL. F S
..:...:....................:::::.:........::::::...
TYPE I HOOD (PER 12' OH 12' PTH. OF HOOD)
:TYPE 11 HOOD
CLOTHES DRYER
............................................
.............................................
........................................
GAS LOG
MISCELLANEOUS'(NOT COVERED ELSEWH , E.
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANCE•>400,000; BTU....;»;">
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 B I U
AIR HANDLER <10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x10.00 =
x 12.00 =
x15.00 =
x 1.00 =
x 12.00 =
x20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
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 =
/
/O, 00
/
/S",OO
,,A
, (j p
SUBTOTAL
$ ...-/-72 00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ -5-,CO
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675