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1992, 11-06 Permit App: 92009823 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM 2 mflertna� Worksheet 13� JOB STREET ADDRESS: 1, ) � 1 E CITY/STATEMP: SGS P tdtiP �� .���a Co In PARCELNUMBER: " OWNER:�ACKAkx,2e dy SEC -RAS PHONENUMBER: q26- LC,2'l MAILING ADDRESS: Y (Street) (City/State) (zip) CONTRACTOR: Heat Transfer Inc. LICENSENUMSER: Heatti-1881n PHONE NUMBER: 328-3400 MAILING ADDRESS: N_ 1008 Ruhv Spokane, WA 99202 (Street) (ChAtate) (Tp) MECHANICAL WORKSHEET/FEE SCHEDULE NOTE: MINIMUM PERMIT FEE IS $35.00 NUMBER OF UNITS X EACH UNIT -AMOUNT x 10.00 = x 25.00 = x10.00= x 12.00 = x 15.00 = x 1.00 = x 12.00 = x 20.00 = x 25.00 = X35.00 = 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 = X10.00 . x 50.00 = X100.00 = X 50.00 = X100.00 - 100.00-x12.00 = X12 -00 x 15.00 = C SUBTOTAL $ .00 PLUS: PROCESSING FEE +$ 25.00' EQUALS: TOTAL PERMIT FEE DUE _$ SIGNATURE Spokane un ty Division of Buildings West 1303 Rrnadwav Avenues Srinkane WA QQ9RD l6nQ1 d5R_AR7S