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1991, 05-17 Permit App: 91002665 Mechanical Fixtures
MECHANICAL PERMIrtAPPLICATION FORM L12-35 Information Wcgfksheet #. SOB STREET ADDRESS: Il/:'4dA [-Rf'T IGgi CITY/STATE/ZIP::p SP1KANF , 11%, qq;) PARCEL NUMBER: OWNER: j_nA 4 1(1 c PHONE NUMBER: GA4-91444 MAILING ADDRESS: :aaf[1F 0.S WY':✓E (Street) (City/State) (zip) CONTRACTOR:',nMQAkn R�UDNr CAr+rpcLs LICENSE NUMBER: Srf'N11vHA3408 PHONE NUMBER: MAILING ADDRESS: SK6T' M NVTCdn[ER ti'G 4 "SAnCANE ,,Iy7A QQZJMC. (Street) (City/State) (zip) ___MECHANI'CAL WORPSHEET/TEE SCHEDULE -.- - -- NUMBER I X EACH DESCRIPTION OF UNITS TWIT = AMOUNT DUCTWORK SYSTEM WOODSTOVE/INSERT _ _ _ _ _ _ _ _ _ _ _ GAS WATER HEATER HEATING EQUIPMENT <100,000 BTU _ _ _ _ HEATING EQUIPMENT +100,000 BTU _ - _ _ _ GAS PIPING (EA OUTLET) _ _ _ _ _ _ _ _ _ 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 _ _ _ HEAT PUMP & AIR CONDITIONER 0-3 TONS _ HEAT PUMP & AIR CONDITIONER 3-15 TONS _ HEAT PUMP & AIR CONDITIONER 15-30 TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS _ HEAT PUMP & AIR CONDITIONER +50 TONS VENTILATING FANS EVAPORATIVE COOLERS_ _ _ _ _ TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE II HOOD______ _ _ CLOTHES--DRYEI[__ _ _ _ _ _ _ _ _ ___ _. RANGE _ _ - _ _ _ _ _ _ _ _ _ GAS IAG 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 >10,000 CFM x$10.00 = x 25.00 = x 10.00 = ln.nn x 12.00 - x 15.00 = x 1.00 = A,nn 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 = finng O x 10.00 - x 10.00 = x 50.00 = x100.00 = x 50.00 - X100.00 = x 12.00 = x 15.00 = SUBTOTAL $ PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT NOTE: MIN ON P/E$/};YT FEE IS $35.00 FEE DUE _ $ 4r(, SIGNATURE,, 4g� slf,�✓+^�� Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (5 9) 456-3675