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1991, 08-19 Permit App: 91005114 Furnace, PipingGAS WATER HEATER +1 BOILER/REFRIG 1-100M BTU BOILER/REFRIG 501-1,000M BTU ,B011p€�iFFFi1G�;1�ia�i�., urs BOILER/REFR16+1,7 M BTU I1EA1'P(�Fv�AlTi'G'ONDI`fPO�iETIJ`�J �._'.., HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT. PUMP & AIR .CONOITIONEO 15=3tl TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS VENTILATING FANS - EVAP6R(AT1VE COOLERSRa •� TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE II FOOD s ,. CLOTHES DRYER RANGE` .... GAS LOG JEOUS(NOT COVERED ELSEWHERE GAS APPLIANCE <400,000 BTU APPLIANCE AIR HANDLER <10,000 CFM AIR HANDLER >1 0,000 CFM -` NUMBER OF UNITS XEACH UNIT ;. MECHANICAL PERMIT APPLICATION FORM , Information Worksheet a.00 JOB STREET ADDRESS:L��- Y 3 a -O. CITY/STATEZIP:.5�� PARCELNUMBER: OWNER:... "Iwe PHONE NUMBER: -' MAILING ADDRESS:_ \.�✓ (Street) kG (City/State) �7- (Zip) TA jP�T j— CONTRACTOR: ASN :/ LICENSE NUMBER:/ I q PHONE NUM13ER: MAILING ADDRESS: - "p„ Z ll' ry i�� (Street)(city/state) •- (Zip) - MECHANICAL WORKSHEET/FEE SCHEDULE GAS WATER HEATER +1 BOILER/REFRIG 1-100M BTU BOILER/REFRIG 501-1,000M BTU ,B011p€�iFFFi1G�;1�ia�i�., urs BOILER/REFR16+1,7 M BTU I1EA1'P(�Fv�AlTi'G'ONDI`fPO�iETIJ`�J �._'.., HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT. PUMP & AIR .CONOITIONEO 15=3tl TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS VENTILATING FANS - EVAP6R(AT1VE COOLERSRa •� TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE II FOOD s ,. CLOTHES DRYER RANGE` .... GAS LOG JEOUS(NOT COVERED ELSEWHERE GAS APPLIANCE <400,000 BTU APPLIANCE AIR HANDLER <10,000 CFM AIR HANDLER >1 0,000 CFM -` NUMBER OF UNITS XEACH UNIT -AMOUNT x 10.00 ... x 25.00 . x10.00..= x12.00. x15.00=. x 1.00 = x 12.00 - x20.00 . w. 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 = a.00 s a -O. SIGNATURE OJSpokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 SUBTOTAL $ ..,0 PLUS: PROCESSING FEE +$ 25.00 EQUALS: TOTAL PERMIT FEE DUE _$e''70 NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE OJSpokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675