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1993, 08-31 Permit App: 93007694 Mechanical Fixtures 93 7 t,9y- MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: ' . 1.:157/ (A.1J//p J CITY/STATE/ZIP: . ia'tp ,r w. PA CEL NUMBER: OWNER: �L. �-,-, v� y,. 4., PHONE NUMBER: gce.-330/ MAILING ADDRESS: < v (Street) (City/State) (Zip) CONTRACTOR: GUL'Y-li, -+ yA-P..., LICENSE NUMBER: 4 .t./-\. l; 0, 5. 3 PHONE NUMBER: yC_,61- yyJ: 9 MAILING ADDRESS: C1. 9(.335 , 0.,�yi ) ` • 7-til / 9/ x a(Street) (Cit State) / (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER I X EACH I I DESCRIPTION OF UNITS UNIT = AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = •... : WOODSTOVE/1N ' ...................................:............................................... x 25.00 = GAS WATER HEATER x 10.00 = G A . � /p,Qp SE U ..M Q P E :> ... ........ ..... ..... ,.;:»<.:0. 000!BTU<:I. G"..;.E >i> <»s ?>s >': .::.:;:.:.....::..........:..::::::.�::.::.�:::::::.�::N:::,;tR�.p::::$>:»>: >::»<::>::�»»:<:<: / x 12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = �� 'DU GA P P.I .. G. ............: ............... ...................::...................... .. ....... ...::.�::.�(:.:::::::::.:.�:>:��::)::.;>::.::::::<:»::; :»>::>:::;::::>::>::::>::>::>::»»::>::::>:>::>::>::>:�>:«<:::: a x 1.00 = BOILER/REFRIG 1-100M BTU . '©O B ::.:::.:.......... x12.00 = 1 ::R/REFRIG 0 -50oM1 T 1 11'f>:<s: > ' ..................:...... ' x 20.00 = BOILERJREFRIG 501-1,000M BTU ` ' •x 25.00 = BOIL Z: ... E E , R F :::.:::..............::f�1. ...1.,000:1:'-1<``:50M:: :: ::>':::::: :»:>: <:>::�;::<:::::>::;<::<:>::>::<:»:: ..............:.::: : :: �:: :: �T.U: > : x 35.00 = BOILER/REFRIG +1,750M BTU :.,. x 60.00 = HEAT PUMP &;AIR:CONDITIONER.0-3<TONS`<<:::<>><><". '`>'' •.., x 1 HEAT PUMP & AIR CONDITIONER 3-15 TONS x 20.00 = HEAT PUMP &:AIR CONDITIONkR1;5-30 TONS <' ;;:>`::;;; x 25.00 = HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 = HEAT PUMP&AIR CONDITIONER +50 TONS :MI VENTILATING FANS x 10.00 = V A P A. TIV..:<:, E ':: ..:::.::::::.:::::.......... ;:: 1ffi...:. . :.: :...::..:. x 10.00 = TYPE I HOOD (PER 12' OR 12' PT-N. OF HOOD) x 50.00 = TYPE II HOOD. x 10.00 = CLOTHES DRYER x 10.00 = RANGE'' x 10.00 - - GAS LOG ....: ....,. .; x10.00 = MISCELLANEOUS(NOT,COVERED;ELSEWHERE .......:......:........ ::: .. x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ULINSTED GAS APPLIAN.CE>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 $ ,,V./-0o PLUS: PROCESSING FEE + $ 25.00 NOTE: MINIMUM PERMIT FEE IS $35.00 EQUALS: TOTAL PERMIT FEE DUE = $ �/c 00 SIGNATURE\ ) 1CN( ,),. Spokane County Division of RtiiIdinnc