1993, 03-18 Permit App: 93001592 ACMECHANICAL PERMITAPPL 6xn0N FORM
InfortnaUan Vyorksheet
JOB STREET ADDRESS:—", �r!C_-
CITY/STATEEMP: Il PARCEL NUMBER: -
OWNER: AOU/lli-7'1 PHONENUMBER:
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: Heat Transfer Inc. LICENSENUMBER: Heatti-1881n
PHONENUMBER:482-2000
MAILING ADDRESS: N. 3003 Crestline Spokane, WA 99207
(Street) (City/state) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
C
GAS EQUIPMENT+100,000 BTU D
P;NG 1EA 0UTLci
&,ILER/REFRIG 1-100M BTU
PUMP 8
rZIM11
TYPE I HOOD (PER 12' OR 12' PTN. OF
JNLISTED GAS APPLIANCE <400,000 BTU
ICI_1:IH��:1
'.OTE: MINIMUM PERMIT FEE IS 135.00
yr Vm.J I - um mgmVVrvl
x 10.00 =
x 25.00 =
x 10.00 =
x 1200 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00
x 25.00 =
'35 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 =
X50.000
50.00 =
X100 =
X1
0.00 =
X1000 =
x 10.00 =
XI
10.00 -
X50 .00 =
x100.00 -
x 50.00 m ..
x100.00 =
x 1200 =
X-15.00 =
Irwa VHUGEs51NU FEE . I +S 25.00 1
DUE I=S 1 D0
IGNATURE ( 7 % _
pokane County Division of Buildings
West 1026 Broadway Avenue Spokane, WA 99260 (509) 456-3675