1991, 11-22 Permit App: 91008138 Mechanical FixturesJOB STREET ADDRESS:_
CITY/STATEOPk
OWNER: I, 30,fc
MAILING ADDRESS: CAA
CONTRACTOR: Heat
MAILING ADDRESS:N
MECHANICAL'PERMFTAPPLICATION FORM
Information Worksheet
mr£ Ad .¢tilX/R
(Street)
Transfer Inc.
1008 Ruhy
(Street)
civ
PARCEL NUMBER:_
PHONE NUMBER:-
(City/State)
LICENSE NUMBER:-
PHONENUMBER:_
Spokane. WA
(City/State)
Qf - :2"1
(vP)
Heatti-1881n
328-3400
99202
(aP)
MECHANICAL WORKSHEET/FEE SCHEDULE
NOTE: MINIMUM PERMIT FEE IS $35.00
NUMBER
OF UNITS
XEACH
UNIT
-AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
x 12.00 -
x 15.00 =
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 -
.2
SUBTOTAL
$
PLUS: PROCESSING FEE
+$ 25.00'
EQUALS: TOTAL PERMIT
FEE DUE
_ $
SIGNATURE
po ne County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675