1993, 02-04 Permit App: 93000615 Mechanical FixturesU
JOB STREET ADDRESS:-
CITY/STATE/ZIP:
OWNER:
Na (0 n wz-- It -
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
PARCEL NUMBER:
PHONE NUMBER: Sal b-)
MAILING ADDRESS:
(Street) (City/State) (zip)
CONTRACTOR: NLU LICENSE NUMBER:_LC& 00H III _XQ tZ,
PHONE
MAILING ADDRESS:
(Street)
(C
MECHANICAL WORKSHEET/FEE SCHEDULE
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(zip)
NUMBER
OF UNITS
XEACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 -
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 -
x 35.00 =
x 60.00 -
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 110.00
x 50.
X100.00
x 50.00
X100.00
x 12.00
X15.00
f.
SUBTOTAL$
PLUS: PROCESSING FEE
+$ 25.00
EQUALS: TOTAL PERIAIT
FEE DUE
=$
Spokane County Division of Buildings
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