1993, 05-06 Permit App: 930053233 Mechanical FixturesJOB STREET ADD
CITY/STAT _ P'
OWNER:
MAILING
G
MECHANICAL PEnMITAPPLICATION FORM
Information Worksheet
4 .
3 33
ALO \a.
dock
Q • PA CEL NUMBER'
CONTRACTOR: /2-
(SVee
MAILING ADDRESS' I /a chi9
(Street)
DESCRIPTION
MECHANICAL WORK
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
Ykpyo Ct( p��,'(('l�'.a n: 111
;�±,,T.(��V:I;�M!i�s�.�;3.`$' &�?:f`. �.."�. ��a:. K.
GAS WATER HEATER
GAS EQUIPMENT
(MEENNT/�1+'1T00,,0100. BTU DUCTWORK)
spp
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG +1,750M BTU
tiffiligtaitiNONg
HEAT PUMP & AIR CONDITIONER 3-15 TONS
itatactEMSSINIMIKSIatit
HEAT PUMP & AIR CONDITIONER 30-50 TONS
VENTILATING FANS
TYPE I HOOD (PER 12'
CLOTHES DRYER
r" ?1w
GAS LOG
Mar
UNLISTED GAS APPLIANCE <400,000 BTU
USED APPLIANCE <400,000 BTU
AIR HANDLER <10,000 CFM
NOTE MINIMUM PERMIT FEE IS $35.00
SIGNATURE
PHONE NUMBER: ?d, - 113A
i
(City/State) (Zip)
LICENSE NUMBER:/vwR&F • /D`P'T7
PHONE NUMBER: 9a,�- 40 g 9
Spa,91.c. 999-/3
(City/State) (Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x25.00 =
/
x 10.00 =
x 12.00 =
x 15.00 -
x 1.00 Z.
x 12.00 =
x 20.00 =
x 25.00 =
x35.00=
x60.00 =
x 12.00 =
x20.00 =
x 25.00 -
x 35.00 -
x 60.00 =
X 10.00 =
X 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x10.00 =
x 10.00 =
x10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 -
x 12.00 =
x 15.00 =
/D . 06
/
/9•.D
.__
02.01
SUBTOTAL
$ ,4 o o
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=s 491.00
Spokane County Division of Buildings
West T3U roadway Avenue Spokane WA 99260
(5091456-3675