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1991, 07-01 Permit App: 91003777 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM `V I• nformation o ksheet *� O STREET ADDRESS: `'r / / q/ `7 =y9 k 'R TY/STATE/ZIP: PARCEL' NUMBE �, 7s j.. ' Y • 0 ER: eOIaG PHONE •NUMBER } 4 4b , �: �w Y> ILING ADDRE :'' ` €r` .., • � , '^"` (Street) „ (City/State) 4 (Zip) ' O TRACTOR:hr LICENSE NUMBER: ' • Iso PHONE NUMBER T ILING`lADDRESS: ` , °• n (Stree ) 24 (City/State (Zip) Ycilc, „ ` s � , MECHANICAL WORKSHEET/FEE SCHEDULE1 . ; NUMBER XEACHr, 4 „r-,' DESCRIPTION OF UNITS UNIT = AMOUNT i';' x$10•, +� R >. • x$10.00 = v ( DUCTWORK SYSTEM__ ' 1 OODSTOVE/INSERT -. x ,25.00 GAS•,.WATER HEATER - _ _ _ _ X'.'-10 0 0 = ;Y HEATING EQUIPMENT <100x000 BTU l'- x '12.00 = ' HEATING EQUIPMENT +100;000 BTU _ _ _ x' 15.00 �• } GAS PIPING (EA-OUTLET)t;_-_ _ _ __ _ �,f. x 1.00 Q3,00 'REFRIG. 1-100M BTU (NOT A/C. OR HEAT PUMP) x• 12.00 ,=, _ FRIG; 101-500M, BTU x 20.00 ,, REFRIG 501-1,000M<BTU-4 I= x. 25.00 7� REFRIG:-1 001-1,75024 BTU _ r ' x, 35.00 t ' REFRIG1+1,750M,BTU :`.- - _ - x #60.00 _ HEATPUMP & AIR CONDITIONER 0-3 TONS; X„x,2.00 ;f'HEAT;PUMP & AIR CONDITIONER 3-15 TONS *30.00 HEAT4PUMP Sr;AIR CONDITIONER 15-30- TONS i''''25.00 HEATS PUMP & AIR` CONDITIONER 30-750 TONS x 35.00 7 EAT,vPUMP: & ;AIR' CONDIT ONER +50 ,TONS _ x,,,,60.00} 7, , ,VENTILATING; FANS {'`'' :'r, ` — _ - °. 10.,00 /4 EVAPORATIVE, COOLERS '-4- _ _ ''•_ _ 41 X, 10.00 77 +'' TAPE I HOOD (PER `12' OR;4 12' FTN. OF HOOD) x50.00 rt w1 t �+ PEII'HOOD ° mss t 00 "' CLOTHES{'DRYER '. — ; 10.00 * SF ; GE ,,4 1 ..,. , e._ " • ,,• ,;p ,, , .4.s., c .N.�.P ,, R X 10 00 .. GA•SB-LOG - — _ _` ; _ �_ ,. -4 _ X10.007; ' . F. MISCELLANEOUS, (NOT `COVEREDr.ELSEWHERE) X 410 00 ` 1."' �x _ � x 'i50:00 411 - tt,k4F. UNLISTED.;GAS :APPLIANCE'<400,000°.BTU u _ .. , -AAA x190.00 A.,,:,--:- 4,• ` kA ''UNLISTED ;GAS` APPLIANCE$>400 000 'BTU ��- � " w ,� ,, USED;APPLIANCE <400,000.`-BTU '.-0,,. " '- xi�50.00 f,; 4,;,,,,,,, ,'¢ 4 USED 'APPLIANCE`t<400,000 400,000- BTU x190.00 "= e 'FAIR' HANDLER <10,000 CFM „,_ • ; ' x•:_12.00 i 7 ,'AIR” HANDLER >10,000 CFM' k gip' X '15.00 FX— t,41^1,t ,mSUBTOTAL ,.7-;',.3F.7: $ 'c doe --„41:, - �1PLUS. PROCESSING FEE + 25.00 f � � FP yk EQUALSTOTALYPERMIT� , j f' '''',,V1,('"' '` • .7NOTE: MI+ UM PERMI EE IS $3 ,'.00 FEE DUE = $ I C 1p � . SIG �\TUR: it O �� / •#"` t® _ ,?,.; Spokane County Department of Building=., and Safety ' " West 1303 Broadway Avenue Spokane, WA 99260 <. (509) 456-3675