1993, 08-05 Permit App: 93006687 Mechanical FixturesOf
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JObt STREET ADDRESS:
CITY/STATE/ZIP:
OWNER:
MAILING ADDRESS: jd712.Q�
MECRANICAL PERMIT -APPLICATION ARM
Information Worksheet
L / Y.e2 `,d&
arrlfz- 14..k
931' 5 7
PARCEL NUMBER:
PHONE NUMBER: 9c2,S7-6,5'2Q..
,//__ (Street)
CONTRACTOR: A�CL��ti r'
(City/State) (Zip)
LICENSE NUMBER:(Jgc-1 3
!,-� � PHONE NUMBER: y�� %a� 9
MAILING ADDRESS: 27. �� 35 pctL��� i'l f�zt. ��'/ /LE . lc.k� /C� �o
(Street) (Cit State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS EQUIPMENT <100,000 BTU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
...............................................
GAS PIPING,(EA OUTLET):.
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 101-5OOM' BTU <` > ;:<: :
BOILERIREFRIG 501-1,000M BTU
BOILER/REFRIG 1.,0001 1,T50M l3TU
BOILER/REFRIG +1,750M BTU
HEAT PUMP>& AIR:` CONDITIONER 0 3:TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT.`PUMP: & N:13;:CONDITIONER 15-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR CONDITIONER 4.5:0 TONS
VENTILATING FANS
............................................................................................ .
..................................................................................................................
EVAPORATIVE C.O.OLERS<>
TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE 11 HOOD
CLOTHES DRYER
RANGE
GAS LOG
...........................:..........................................................................
MISCELLANEOUS'(NOT COVERED: ELSEWHERE .
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANCE >400.000 BTU
USED APPLIANCE <400,000 BTU
USED.; APPLIANCE;>400,000 BTU.
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
x 12.00 --
x 15.00 =
x
x 1.00 =
x 12.00 =
x20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
cl
, 00
1
gyp, jpO
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
SUBTOTAL
$ /.-, Oct
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ -37,00
Spokane County Division of Buildings
West 1303 Broadway Avenue SDokane. WA gq2Fn «n4� 4�f;_ 2R7R
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