1993, 10-11 Permit App: 93009567 Mechanical Fixtures MEGHANVICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: q 1 l Li L ,'o
CITY/STATE/ZIP: SP1 1 ae. 1.4)(1.....
,kle, 920( PARCEL NUMBER:
OWNER: 1 _ r f.1.4 ark- PHONE NUMBER:
MAILING ADDRESS: 6øi-4-
CONTRACTOR: I I1 ew 5 e e heasrc4 ( LICENSE NUMBER: II/v�A/ 7 -1I/3 g3
,t PHONE NUMBER:Iiig 4-31�ZS
G
MAILING ADDRESS: /5-0 3 t)€b tis I s/Jp Ru+t e_14 )*54 61 1 %U
(Street) " (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT =AMOUNT
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 =
25.
x 00 =
GAS WATER HEATER x 10.00 = /0,6 O
x 12.00 =
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
x 1.00 =
BOILER/REFRIG 1-100M BTU x 12.00 =
x2
20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
B`� , ; :::;.:,`.>.::..,`` _. ,,,. :::::MPQMVM;;:.;:.>:.I;:.;:.;:.;:.;:.;:.;: .:;:;:.;;::.»:.>:.;:.;: x 35.00
BOILER/REFRIG +1,750M BTU x 60.00 =
2.
x 12.00 =
HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 =
x25.00 =
H F�4'I<`�I�.1.�tf''�>1�tlt> ON....I....1�....1=�..1.5- t)....:Q�I�..............:......
HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 =
}::::;::4'.;. ;�}:::'.i:::...vr::•i::C:{::i.i::i::ii:<:i::i:: i:i::::ii::::ii
:W EA'i<` :;:.>.lutP `AI'::<: . `: >1'CI:> I�:::f: . ;>T.' .. ::::::<:::>:::>::«: :<:>::::>:;>::>::
x 60.00
VENTILATING FANS x 10.00 =
1
x 0.00 =
TYPE I HOOD(PER 12' OR 12' PTN. OF HOOD) x 50.00 =
1
x 0.00 =
CLOTHES DRYER x 10.00 =
iimpgaggagaggingspiiiitimiiiiiimaiiiiiinnimaiiiiiimou
x10.00 =
GAS LOG x 10.00 =
MI6gg414g0U:6 NQ'I"PPP:tEPigISVIigfie<> inn
x 10.00
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
x1 0.00=
USED APPLIANCE<400,000 BTU x 50.00 =
...........................................................................................................................................
............................................................................................................................................
Eb`/IPP ' : :. .�±t .:`.>.:': :::: <n><>>>' <��>'>>'>> > >>> >>>< x100.00
............................................................................................................................................
AIR HANDLER<10,000 CFM x 12.00 =
.........................................................................................................................................
AI
x 15.00 =
SUBTOTAL $ 44,,0 6
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE =$ 41,(0
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
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