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1992, 10-16 Permit App: 92009016 Mechanical Fixtures ( \a-(-)I01 (0 L&JD c,f1 PO_ MECHANICAL PERMIT APPLICATION FORM 4-titfi_,./3• . auInformationWorksheetIIa0. �- p JOB STREET ADD ESS: 6 So a_ JL I V I U ��!'�L� CITY/STATE/ZIP• / 4. , �a• 0,3 14-,i PARCEL NUMBER: o(-7 l - L, ,(i1 in �3 OWNER: ( .4a- lz-d- PHONE NUMBER: % /- & 760 9 MAILING ADDRESS: -A-rte- (Street) (City/State) (Zip) CONTRACTOR: 2 w.i Ai,c_ -u i C LICENSE NUMBER: AI DRi E gm C JO g T'7 PHONE NUMBER: ,-,. -- /D f�' MAILING ADDRESS: l" -�', --JO-Y-- /-3 4L/9 & c2- • q9.-2/3 'j On (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = WOQDSTOVE/INSERT .. ........ ...::........ . x 25.00 = GAS WATER HEATER x 10.00 = GAS EQUIPMENT.100,000BTU(INCLUDES ... ......... / x 12.00 = /,. .0 o GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = GAS PIPING (EA OUTLET). .. ......." : ::::: . . . : / x 1.00 = i.ee) BOILER/REFRIG 1-100M BTU x 12.00 = BOILEIR/REFRIG 101.-500M BTU: . ...><:>::>;.:>: ...:.... : x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = BOILER/l EFRIG 1,0001 1,750MBTU ' :....:: . . x 35.00 = BOILER/REFRIG +1,750M BTU x 60.00 = HEAT PUMP&AIR CONDITIONNER 0:-3 TONS x 12.00 = HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 = HEATPUMP&AIR CONDITIONER 15.30 TONS x 25.00 = HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 = HEAT PUMP&AIR CONDITIONER+50 TONS ....:: x 60.00 = VENTILATING FANS x 10.00 = EVAPORATIVE COOLERS ..... ..;.: : ... . : >. x 10.00:. .:;.. TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = TYPE II HOOD: x 10.00 = ..:::*::..................... .........K:::i...x*::: :..:.:........:: ::::... CLOTHES DRYER x 10.00 = . RANGE:......: x 10.00 = GAS LOG x 10.00 = MISCELLANEOUS(NOT COVERED ELSEWHERE : x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ULINSTEDGAS APPLIANCE>400,000 RTU.. . : x100.00= USED APPLIANCE<400,000 BTU x 50.00 = USED APP .IANCE>400,000 BTU . x100.00 = AIR HANDLER<10,000 CFM x 12.00 = AIR HANDLER>10,000 GFM :. . x 15.00 = SUBTOTAL $ /3 .6D PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE =$ -3(00 SIGNATURE a- )1 7) ` t S okane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675