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1993, 02-08 Permit App: 93000694 Mechanical FixturesJOB STREET 7� MECHANICAL PERMIT APPLICATION FORM 1Infoi^ation Worksheet /04D1-11 (Street) PARCEL NUM PHONE NUME CONTRACTOR: Ra nnr Fu -ac- 6 Mmi - IIns110ENSE NUMBER: 13 EFF378NT CONTACT! RUSS LUNDF. PHONE NUMBER: 535-1711 MAILING ADDRESS: P.O. Box 4346 Spokane, WA. 99202 (Street) (City/Slate) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) W66DST6VEIIN8ERT,. GAS WATER HEATER GAS EQUIPMENT 4100,000 BTU DUCTWORK) GAS PIPING (EA OUTLET) HEAT PUMP & AIR CONDITIONER 6=3 TONS HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT PUMP &'AIR CONDITIONER I5=30'.TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMP & AIR CONDITIONER X50 TONS VENTILATING FANS EVAPORATIVE COOLERS TYPE I HOOD (PER 12' OR 12 PTN. OF HOOD) TYPE It HOOD CLOTHES DRYER RANGE GAS LOG MISCELLANEOUS (NOT,bOVEREb ELSEWHERE UNLISTED GAS APPLIANCE <400,000 RTU ULINSTED GAS APPLIANCE :>400,OOd BTU USED APPLIANCE <400,000 BTU USED APPLIANCE >400.60d BTU AIR HANDLER <10,000 CFM AIR HANDLER>1Q000 CFM" 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 = k 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 = 000.00 = x 12.00 = x 15.00 = SUBTOTAL S. PLUS: PROCESSING FEE E 25.00 EQUALS: TOTAL PERMIT FEE DUE =5 3 .Qp SIGNATURcet ...SLCiaApj1.�+�e rr "' Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675