1992, 10-21 Permit App: 92009155 Mechanical Fixtures 5 `b, MECHANICAL PERMIT APPLICATION F01.141 C .2"
Info:oration Worksheet Q
JOB STREET ADDRESS: �(� 02 �� �it)de -01-act- \OIO
CITY/STAT//��E/ZIP: VD lbw-L-1 ,j'4- 9 9t .O é PARCEL NUMBER:
OWNER:!_5uie•e7fAt'K/!% /414'5 ` PHONE NUMBER:(5C9) Qc "��C
MAILING ADDRESS: 3 --o 2- S', uJ1fc dam'. S ►o cAJA, 19 a•G
� o (Street) (City/State) (Zip)
CONTRACTOR: c//,J,47 /4,4-744.1 , LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(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 HEATER1000
1 x . = 1C7 •00
;0AsiigovipmgKr<100,000 I TU (INCLUDES ;.;': : I x 12.00 = 12,00
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = A..:: ...... .. .. ......
GAS PIPING( UT
OLET) :<_:>:;;»>>:::::>:::;'' x 1.00 = 4 .O0
BOILER/REFRIG 1-100M BTU x 12.00 =
x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
x 35.00 =
BOILER/REFRIG +1,750M BTU x 60.00 =
HEAL`PUMP&AIR COND TIONER 0 TONS x 12.00 =
HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 =
HEAT PUMP&AIR' NDITIONEIS 15.30 TONS ; x 25.00 =
HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 =
HEAD"
PutiA-P&,:AtFt CONDITIONER+50 TONS ` <>: 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..........::: c2E?C.iAC ........1.f1f-? Z`-7:::::..:........... Z x 10.00 = ZP.G0
M$SCELLA EOUS(NOT COVERED ELSEWHERE x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINSTED GAS APPLIANC 400, 10 BTU'''` x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
U ED API LIANCE a4 ,000 BTU.. x100.00=
AIR HANDLER<10,000 CFM x 12.00 =
AIR HANDLER 10,000 CFM <..:> >< ' x 15.00 =
SUBTOTAL $
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE =$ li, op
SIGNATUR�' _
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675