1991, 11-12 Permit App: 91007740 Mechanical FixturesTOB STREET ADDRESS:
MECHANICAL PERMIT APPLICATION FORM
Intprmation Worksheet
I l L 3 sP- A, C
CITY/STATE/ZIP: ��-. ckci aZ l a PARCEL
OWNER: ArVA N 1-11,A 3n'P A\ PHONE
F I t \ 3 - 9" As1
MAILING ADDRESS:
(Street)
CONTRACTOR' (.I� bh�`c �z}� ‘Aa r‘7\ -1w\3,
MAILING ADDRESS:
NUMBER:
NUMBER: Ca�5i401
(.�w 1a
(city/state) (Zip)
LICENSE NUMBER: r; 1 %4 T, TW C \-7 L-, CC.
PHONE NUMBER: boas
ave._ \9\ --Th c(,Ftarn
(City/State) (Zip)
F) S - - 37' A.,.6)
(Street)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS 'UNIT
DESCRIPTION
= AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
BTU
BTU
HEATING EQUIPMENT <100,000
HEATING EQUIPMENT +100,000
GAS PIPING (1 - 4 OUTLETS)
GAS PIPING (5 OR MORE. EACH:)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
0-3 TONS.
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
EVAPORATIVE COOLERS
TYPE I HOOD (PER. 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE)
UNLISTED GAS APPLIANCE <400,000 BTU
UNLISTED GAS APPLIANCE >400,000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM _
AIR HANDLER >10 *tOCc'9IV E
NOV 7 1991
aua.01NG 13i. SAFETY
NOTE: l MINIMUM PERMIT
F IS $3 00
.
SIGNATURE ES. %wo.S.0 LLt11
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 4.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
X r0
SUBTOTAL SUBTOTAL
$ 141.o°
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane Coon ertment of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675