1989, 06-27 Permit App: 89001952 Mechanical Fixtures AS
�� MECHANICAL PERMIT APPtirCATION FORM 620)(a
Information� Worksheet F/
E5-.73 J�
JOB STREET ADDRESS: 73 it 4 (
CITY/STATE/ZIP /. ' s ��w7/, PARCEL NUMBER: 0551/-6//C _
OWNER: / a?)0.7)-',4A ,
PHONE NUMBER: - 7 7
MAI LING ADDRESS: .3 c'-n/1l� 2Z/
(Street) (City/State) (Zip)
CONTRACTOR: A 0 F� Q °s'.',�Ta ,...., 1pa Jv LICENSE NUMBER: 14/�iLAHE /dl A//
E. 12710 InJiana PHONE NUMBER: 9a , -,Q/O Q
Spokane, G'asilin ion 99`''.3
MAILING ADDRESS:
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
I NUMBER I X EACH
DESCRIPTION yF UNITS UNIT = AMOUNT
DUCTWORK SYSTEM x$10. 00 =
WOODSTOVE/INSERT x 25.00 =
GAS WATER HEATER x 10. 00 =
HEATING EQUIPMENT <100, 000 BTU r x 12.00 = (c2 , OQ
HEATING EQUIPMENT +100,000 BTU x 15. 00 =
GAS PIPING (1 - 4 OUTLETS) r x 4. 00 = 4. 00
GAS PIVING (5 OR MORE. EACH: ) x 1. 00 =
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12. 00 =
REFRIG 101-500M BTU x 20. 00 =
REFRIG 501-1,000M BTU x 25. 00 =
REFRIG 1,001-1,750M BTU x 35. 00 =
REFRIG +1,750M BTU x 60. 00 =
HEAT PUMP & AIR CONDITIONER 0-3 TONS _ _ ( x 12. 00 = te2 , p
HEAT PUMP & AIR CONDITIONER 3-15 TONS _ x 20. 00 =
HEAT PUMP & 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 =
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 =
UNLISTED GAS APPLIANCE >400, 000 BTU_ _ _ x100. 00 =
USED APPLIANCE <400, 000 BTU x 50. 00 =
USED APPLIANCE >400, 000 BTU x100. 00 =
AIR HANDLER <10, 000 CFM x 12 . 00 =
AIR HANDLER >10, 000 CFM x 15. 00 =
SUBTOTAL $ r2E OD
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT
NOTE: M IMSM PERM T FEE IS $35.00 FEE DUE = $ S-3,6 0
SIGNATURE ,
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675