Loading...
1993, 03-03 Permit App: 93001228 Gas Log MECHANICAL PERMIT APPLICATION FORM 3-6 228 Information Worksheet Z 4o0 f3 JOB STREET ADDRESS: ; /, cy CITY/STATE/ZIP: e ala^kLit )-1,..921)-(7 , PARCEL NUMBER: OWNER: i C , L.h �- PHONE NUMBER: q2 9.//‘74 MAILING ADDRESS: 1117,7 i r ; 'c,,; c- (Street) ( ity/State) (Zip) CONTRACTOR: 4/0 CCJ le; --P LICENSE NUMBER: ,I to d 75 i�s. 1 PHONE NUMBER: MAILING ADDRESS: r '9-et_0�"-€ 4-E'S� , - �p,✓v� c` (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = x 25.00 = GAS WATER HEATER:::::.............................................................................. x 10.00 = .......................................................................................................................................... ............................................................................................................................................ x 12.00 = GAS............:....::...............::.......................................:..............:....O...:..................:............ S EQUIPMENT+100,000 BTU DUCTWRK) x 15.00 = ............................................................................................................................................ x 1.00 = BOILER/REFRIG 1-100M BTU x 12.00 = ........................................................................................................................................... ........................................................................................................................................... x 20.00 = ...B....O........IL....E.......R......./....R........E.......F.......R.......I...G...........5...0......1....-.......1......,0...0......0.......M............B...T......0.......................................................................................................... x 25.00 = x 35.00 = ................... .....................................................:............................................:..........:...... BOILER/REFRIG +1,750M BTU x 60.00 = ......................................................................................................................................... ............................................................................................................................................ HEAT.PUMP AIR�CONDIT ONE i..D- TANS x 12.00 = .........................................:.............:.................:............................................................... ....................................................................................................................................... HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 = ............................................................................................................................................ HEAT'PUMP&''AIR CONDITIONER 15-30TONS... >:`` x 25.00 = ......................................................................................................................................... ............................................................................................................................................ HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 = ............................................................................................................................................ HEAT PUMP. AIR.0 NDITIONER+50 TANS. x 60.00 = VENTILATING FANS:::::::................................................................................. x 10.00 = ............................................................................... ............................................................................................................................................ x 10.00 = .......................................................................................................................................... ............................................................................................................................................ TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = ........................................................................................................................................... ............................................................................................................................................ x 10.00 = .................................................................. ........................................................................................................................................... ......................... ................................................................................................................ CLOTHES DRYER x 10.00 = x 10.00 = GAS LOG 4c S �/vT��� , �'j 7, 1 x10.00 = I ' -y NEOUS(NOT COVERED PLr rP:E - / ._ 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = .......................................................................................................................................... ULINSTEDGAS APPLIANCE>400,000 BTU:::`::.`: :: x100.00= ...........:......::......................::...........:......:............................................................................: USED APPLIANCE<400,000 BTU x 50.00 = .......................................................................................................................................... ............................................................................................................................................ x100.00 = .........::.....::........:..........::..................................................................................................... AIR HANDLER<10,000 CFM x 12.00 = .......................................................................................................................................... ........................................................................................................................................... x 15.00 = SUBTOTAL $ PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE =$ � : SIGNATUREz r�-t'� ;.r Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675