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1992, 09-25 Permit App: 92008088 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: 7,-;1 /7�' C' ��- " g L CITY/STAT : \ i(• Gt_V1 7 9&/6, PARCEL NUMBER: 5273• z16gj OWNER: f rig k( j/j7 ��' .1 ) PHONE NUMBER: 9,-2 (U7 MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: t)(1/?0C� // 7t& (, LICENSE NUMBER: /L)L)/Z 2('1//1'/ --20, 2 PHONE NUMBER .3t-/6(97_5-- MAILING (97_5MAILING ADDRESS: E • ._/16) - 72 6YU ".�L)- tz-)i2 99_2/ (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION _OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = ........................................................................................................................................... W000STOVE/INSERT.: : <. x 25.00 = GAS WATER HEATER x 10.00 = /C. 527 GAS EQUIPMENT! x 12.00 = ,J . OD GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = x 1.00 = d. BOILER/REFRIG 1-100M BTU x 12.00 = SQILER/REFRIG 101::500M BTU ; x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = SO,ILERJR E IG.1,0001 1, 0M 8TU 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 15-30 TONS x 25.00 = ....... .................................................................................................................................. HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 = HEAT PUMP.&AIR`CONDITIONER;+50 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 = ...... ...... ......................................................................................................................... TY:PEII:HOQD ;; x10.00 = CLOTHES DRYER x 10.00 = ... . . .......... .......................................................................... ........................................... RANGE x 10.00 = GAS LOG x 10.00 = ...................................................................................................................................... MISCELLANEOUS(NOT COVERED ELSEWHER>* )( 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 5610 = ULINSTED GAS APPLIANCE>400 000 BTU x100.00 = USED APPLIANCE<400,000 BTU x 50.00 = USED APPLIANCE X400,000 BTU : x100.00 = AIR HANDLER <10,000 CFM x 12.00 = AIR HANDLER>10,00.0 CFM; x 15.00 = SUBTOTAL $ J-Y,a G PLUS: PROCESSING FEE + $ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE = $ SIGNATURE 7//1(--y.. /1/44 Spokane County Division of Buildings west 1 13raadway Avenue Spokane, WA 99260 (509) 456-3675