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1992, 12-23 Permit App: 92011146 Mechanical Fixtures (+52 Z1 �f MECHANICAL PERMIT APPLICATION FORM �2 L.- g , 6 .. - --,----qua__ - h� 1 )Information Worksheet JOB STREET ADDRESS: S S. A 7/(. ' �J€JL f k^t LU �g CITY/STAT IP.SpQ. Lon cm â1&Q PARCEL NUMBER: OWNER: i:rid a . L 0 e Q PHONE NUMBER: , , -ff,;12O MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR:101C0 z _e n U'1V LICENSE NUMBER: PC)/7 on HAAl-7011-z PHONE NUMBER: . Ci 3q-41 q 7S MAILING ADDRESS: E . 5/o3 111_1/71-' o_SpL/ (19(:)Q (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT = AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = ..............................................................._......................................................................... ................. ......................................................................................................................... WOODSTOVE/LNSERT x 25.00 = ......................... .................... ......... .... .............. ........... .......... . ................ ........................................................................................................................................... GAS WATER HEATER --N, x 10.00 = / GAS EQUIPMENT<1.00,000::aTU{INCLUDES -, x 12.00 = / , GAS EQUIPMENT+100,000 BTU DUCTWORK) * x 15.00 = _ GAS PIPING (EA©UTA. ,.:..... .: . : . ...: . ` x 1.00 = /12, d) BOILER/REFRIG 1-100M BTU x 12.00 = :iipolL .FvRa.FFoq.101:4400.1.wiirog,;:iiiBiniiiiiiimigigsi!iiiiscx 20,00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = BOILER/REFHIG 1,0001-10M RTU : x 35.00 = BOILER/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;1.5 30 TONS : :. x 25.00 = HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35,00 = HEAT PUMP &;AIR CONDITIONER`+60 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 1,0.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ULINSTED GAS APPLIANCE>400,000 BTU x100.00 = USED APPLIANCE<400,000 BTU x 50.00 = USED APPL,UANCE>400,000 BTU x100.00 = AIR HANDLER <10,000 CFM x 12.00 = . ........................ ........... ............... .................................... ...... ................................ AIR HANDIER>10,000 CFM x 15.00 = SUBTOTAL $ 091/(Jj� PLUS: PROCESSING FEE + $ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT (//9 a FEE DUE =$ k SIGNATUREL - ----(_,_1712.-- Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675