1992, 07-06 Permit App: 92004967 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORA, .._4-4!4R,,_(4/7,,/
Intor tioA Worksheet e//- ----7t:.
JOB STREET ADDRESS: /'/ -////// /1 ) (( --,47L--- (/,
CITY/STATE/ZIP: Li 7�- --, %2/v
'�/ 2 p�PARCEL NUMBER: T / f
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f�; PHONE NUMBER: SJR �// n
OWNER:�� v' c�' s
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MAILING ADDRESS: -..!V�r°-c , 1
(Street) (City/State) (Zip) i
CONTRACTOR: s-A11. t*w.- d- Art-. c--.LICENSE NUMBER: 14orrV--"317---6-- a()0 6 -
ii PHONE NUMBER:
MAILING ADDRESS: L( ir ((-, 4 3 l cel L
(Street) (City/State) (Zip) 4
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT = AMOUNT
DUCTWORK SYSTEM x$10.00 =
WOODSTOVE/INSERT x 25.00 =
GAS WATER HEATER / x 10.00 = iG -r=C
HEATING EQUIPMENT <100,000 BTU / x 12.00 = / -
HEATING EQUIPMENT +100,000 BTU x 15.00 = "
GAS PIPING (1 - 4 OUTLETS) x 4.00 = _ .4,-4- 1- 7.. ....-
GAS PIING (5 OR MORE. EACH:) 2 _ x 1.00 = _
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12.00 =
REFRIG 101-500M BTU x 20.00 = r
REFRIG 501-1,000M BTU x 25.00 =
REFRIG 1,001-1,750M BTU x 35.00 =
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 = r
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
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 10.00 = .:
UNLISTED GAS APPLIANCE <400,000 BTU _ _ x 50.00 = '=
UNLISTED GAS APPLIANCE >400,000 BTU _ _ x100.00 =
USED APPLIANCE <400,000 BTU x 50.00 =
USED APPLIANCE >400,000 BTU x100.00 =
AIR HANDLER <10,000 CFM x 12.00 =
AIR HANDLER >10,000 CFM x 15.00 =
SUBTOTAL $ ,.,{4 C
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT 90-
NOTE: IMUM PERMIT FEE = $35.00 FEE DUE
SIGNATURE ,�, :'i< `�i.�_ ^
Spokane ounty Department of Building and Safety A