1989, 05-31 Permit App: 89001506 Mechanical Fixtures 1
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MECHANICAL PERMITLAPPLICATION FORM
Information Worksheet
, , OB STREET ADDRE : o�. /02/7,,''' /, iii,
'ITY/STATE/ZIP: pc7Gl t vin t'I�(-•�H'� PARCEL NUMBER:
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,WNER: )r� // 0 __ l V t � y�,C tCI)ONE NUMBER:
s : AILING ADDRE •
it (Street) (City/State (Zip)
11 'ONTRACTOR: 6/ t,� (", 9C) j/ J,ICENSE NUMBER: .a/,, 5 /;)`r/(14f
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PHQ�E��N�UMBER, z �C C)
. [AILING ADDRESS pl ' //I7(' JJ _�� i -�
� (Street) ( iity/State) (Zip)
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MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT = AMOUNT
)UCTWORK SYSTEM 4 x$ 6.50 = i7,1
IOODSTOVE/INSERT x 10.00 =
;AS WATER HEATER / x 6. 50 = U
a [EATING EQUIPMENT <100, 000 BTU / x 9 . 00 = C '-;
' 1 [EATING EQUIPMENT +100, 000 BTU x 11. 00 =
1 ;AS PIPING (EACH OUTLET: ) x . 50 = / , C .
ZEFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 9. 00 =
j :EFRIG 101-500M BTU x 16. 50 =
ZEFRIG 501-1, 000M BTU x 22 . 50 =
H :EFRIG 1, 001-1, 750M BTU x 33 .50 =
:EFRIG +1,750M BTU x 56. 00 =
[EAT PUMP & AIR CONDITIONER 0-3 TONS _ _ x 9.00 =
[EAT PUMP & AIR CONDITIONER 3-15 TONS _ x 16.50 =
! ; [EAT PUMP & AIR CONDITIONER 15-30 TONS _ x 22 .50 =
1 [EAT PUMP & AIR CONDITIONER 30-50 TONS x 33 . 50 =
H [EAT PUMP & AIR CONDITIONER +50 TONS x 56. 00 =
'ENTILATING FANS _ _ _ x 4 . 50 =
IF :VAPORATIVE COOLERS Ix 6. 50 =
11 [GODS x 6. 50 =
� 1 :LOTHES DRYER x 6.50 =
I ZANGE x 6. 50 =
,, =AS LOG x 6. 50 =
t;
JNLISTED GAS APPLIANCE x 20. 00 =
. 1 SIR HANDLER - 10, 000 CFM x 9 . 00 =
I SUBTOTAL $ / /5()
}` PLUS: PROCESSING FEE + $ 15. 00
r EQUALS: TOTAL PERMIT ---7/ (7'
NOT^ : MINI UM PERMIT FEE IS $20.00 FEE DUE = $ � -_
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Signa e -' - - A .IQ_
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Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675