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1993, 04-09 Permit App: 93002324 Mechanical FixturesMECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) .......... •�0 GAS WATER HEATER Mir .1 W.F.I.S. 1.1.11,0A.P.10 T RN - - GAS EQUIPMENT +100,000 BTU DUCTWORK) a BOILER/REFRIG 1-100M BTU BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG +11.750M BTU HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS VENTILATING FANS TYPE I HOOD (PER 12' OR 12'PTN OF HOOD) CLOTHES DRYER GAS LOG UNLISTED GAS APPLIANCE <400,000 BTU USED APPLIANCE <400,000 BTU f I AIR HANDLER <10,000 CFM NOTE-- MINIMUM PERMIT FEE IS $35.00 NUMBER X EACH OF UNITS UNIT =AMOUNT MECHANICAL PERMIT APPLICATION FORM x 10.00 x 12.00 ja 00 Information Worksheet x 15.00 JOB STREET ADDRESS: 2 X 12.00 X 20.00 CITY/STATE/ZIP: PARCEL NUMBER: OWNER: YYI 0-n PHONE NUMBER: MAILING ADDRESS: f-- 0,im ye,(Street) x 35.00 (City/State) (zip) x 10.00 = x 10.00 = x 50.00 = x 10.00 - CONTRACTOR: LICENSE NUMBER: x 10.00 = PHONE NUMBER: MAILING ADDRESS: x 50.00 = x100.00 - (Street) (City/State) (zip) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) .......... •�0 GAS WATER HEATER Mir .1 W.F.I.S. 1.1.11,0A.P.10 T RN - - GAS EQUIPMENT +100,000 BTU DUCTWORK) a BOILER/REFRIG 1-100M BTU BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG +11.750M BTU HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS VENTILATING FANS TYPE I HOOD (PER 12' OR 12'PTN OF HOOD) CLOTHES DRYER GAS LOG UNLISTED GAS APPLIANCE <400,000 BTU USED APPLIANCE <400,000 BTU f I AIR HANDLER <10,000 CFM NOTE-- MINIMUM PERMIT FEE IS $35.00 NUMBER X EACH OF UNITS UNIT =AMOUNT x 10.00 x 25.00 x 10.00 x 12.00 ja 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 10.00 = x 50.00 = x100.00 - x 50.00 = x100.00 = x 12.00 = x 15.00 = SUBTOTAL $ n 3 c(' PLUS: PROCESSING FEE +$ 25.00 EQUALS: TOTAL PERMIT FEE DUE =s UO SIGNATURE Spokane County Division of Buildings \A/ncztlqOqRrnnriwnvAvpniip.';nnknnp.WA 99260(509)456-3675