Loading...
1992, 08-14 Permit App: 92006444 Mechanical Fixtures tAsD13 - a`1o5 ,�,��,�, l,'� MECHANICAL PERMIT APPLICATION FORM _ �� Q Information Worksheet -51S(-11 JOB STREET ADDRESS: )<-2 2 X?-/'-e/'.- CITY/STATE/ZIP: c-*/4 / .1 ' -9�> // PARCEL NUMBER: OWNER: D4_,,-). i j fE PHONE NUMBER: 4)/r- `--5 -2 ,77 MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: /-`�" ,- s d ' /1e �- - /7(.0,e74- LICENSE NUMBER: A/(1../../Z-1/379,-49 /13 17/ PHONE NUMBER: MAILING ADDRESS: ---:Of .2 �'4 55C-<- .- /6271 � <-�-7 (Street) (City/Sta e) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = WOODSTOVE/INSERT ` . ``s`< x 25.00 = GAS WATER HEATER ..... ............, / x 10.00 = o, GAS EQUIPNT< ME100,000 BTU(INCLUDES ,;:;" ` ____ x 12.00 = /a. 6\U GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 - G 5::p e>Na(EA£?ongr .... ,,. ..;....... .. .... .... 2 x 1.00 = -s? BOILER/REFRIG 1-100M BTU x 12.00 = CLL EERIO 101-500M ETU........ ;:. :..:iii:E.;::.;:.:..; x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = BOILER/REFRIG 1 0001 1,750M S7U:;: ' :::: x 35.00 = BOILER/REFRIG +1,750M BTU x 60.00 = :.... .:...: ::: PUMP$AIR CONDITIONER 0-3 TONS .-+- x 12.00 = HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = :E:.;T PUMP&AIR CONDITIONER 15 3O:TONS . ........ x 25.00 = HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 = HEATPUMP AIR CONDITIONER+50 TONS >:::' > x 60.00 = VENTILATING FANS x 10.00 = EVAP AT(V :. ' : :::::: :: E `: :: : :: ::: : :.:.; ::: .:.;:.;:.;;;: : ..;;.;:_;.;:.;;:.;;:;.;:.;:.;;:.;:.;:. . ;:.;;: ::>::::>::»> ;. x 10.00 = TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = TYPE.II LOOD::. ......: ::::::liBil::: ::::::::::::;::`>;>: :niiii: ........ini ...........:...................... ................................................................ _ x 10.00 = CLOTHES DRYER x 10.00 = R AG,>R':EN.i.$$Mi$i:' i i i`fi i i iii:EE:� iigli igi i i iii1M i'ii�'161i NG1=...:.. . ....: x 10.00 = GAS LOG - x10.00 = LA MISCELNEOUS NQTCOVERED ELSEWHERE : :::::<::<; x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ULINSTED GAS APPLIANCE>400,000 :: ::: <<>.: .` ' x100.00= USED APPLIANCE<400,000 BTU x 50.00 = USED APPLIANCE>400,000 ETU......:: >>::: iiii'': ..:iii!ii: : ::::::: x100.00= AIR HANDLER<10,000 CFM TM. x 12.00 =......................................ILER yi0,D00 CFM ;:: <<<>:: . n x 15.00 = AUG 1 3 1' SUBTOTAL $ o?V BU PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 DIId , `S/` LQUALS: TOTAL PERMIT FEE DUE = $ . l, SIGNATURE l Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675