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1993, 01-12 Permit App: 93000028 Mechanical Fixtures
MECHANICAL PERMIT APPLICATION FORM q-5- d / 1 (A Information Worksheet JOB STREET ADDRESS: 552) CITY/STATE/ZIP: P.0/‘,)0.14- PARCEL NUMBER: ff OWNER: VOOq--r6 itJ PHONE NUMBER: 4?2 - )?_, MAILING ADDRESS: (Street) (City/State) (Zip) p, CONTRACTOR: 111.9-7-11.- at(m4Jr7 LICENSE NUMBER: A/ �kGS/G27c. PHONE NUMBER: 9O MAILING ADDRESS: /� A/O , ' ©4 (.44,i-- 9 (,Z (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = l'W - = ::. ::::: :: :..:..: .................................. x 25.00 GAS WATER HEATER / x 10.00 = 2. = :: �S>��Uli?MgI�>(`>�i40�ty:Old '�'J`<:Int,�;;;;:::S>:>;:;;::.;:>;:;:.::,;;::<.;:. xi 00 GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = GAS1'01.4G.( OU C .... 1. 0 = ... ...... x 0 BOILER/REFRIG 1-100M BTU x 12.00 = B:>11EiV1V:>RIG>iO4.1viii)M....'tW....... 2 ...:.::::::::.�::.�:::::......................:::. x 0.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = x 35.00 = BOILER/REFRIG +1,750M BTU x 60.00 = :N =.::UM1t :<AtE:talta'1'LwN Ot.;:;Q::<:.�..;;;;:-;;:,:.;:.;:.:;;;:.;:.;;:<.:: x1 12.00 = HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 = 2 .00 = H 5A'�`:;1':: M�:::�::�l l�> �1I�IIW EI�'I 5: r<:.;:;ONS:.>:.;:.;:.::.;;;:.:;:.;:.;:.: x 5 HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 = x 60.00 = VENTILATING FANS x 10.00 = x 10.00 TYPE I HOOD (PER 12' OR 12' *P. TN-. OF HOOD) x 50.00 = x 10.00 = CLOTHES DRYER x 10.00 = x 10.00 = GAS LOG x 10.00 = :, �'`E111119 x 10.00 = 't�t$G>=LfAN��C1S t�Q')'>CSX/��6D<�4-�.::::::::::.;::.;:.;;;:::,:.;>;;>;::.;;;: UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ;41 li NSr.0b.:+.GAS;:APS?CtANOEQQ000> , ;:.;> .;:.;;;;;; .:,;;:.::.:. x100.00= USED APPLIANCE<400,000 BTU x 50.00 = x100.00= AIR HANDLER<10,000 CFM x 12.00 = Ala:HANnLSt�;� �,�da: p0 x 15.00 = SUBTOTAL $ /L( 10 PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT /JQ " FEE DUE = $ SIGNATURE l'k `\1okane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675