1993, 04-15 Permit: 93002528 Wood Stove (2)25
MECHANICAL PERMIT APPLICATION FORM dCD
Information Worksheet
JOB STREET ADDRESS: N Lid 3 Cc' i A/ /' b
CITY/STATE/ZIP: 6I -F. En/fltAtF-Y , ct/ /4 Gl40/lo PARCEL NUMBER:
OWNER: �/LF&2f1 y PHONE NUMBER:
MAILING ADDRESS: N. +103 L 11 3 12_7) .' Lel R- Qqe.'/>
(Street) (City/State) (ZIP)
LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
Cc2 , IN RDO 'to Cd+eel4""
1b3 - d(oS� "�
�oZ r-0; 3 3 �'
CONTRACTOR: AV/i4
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
.„>Fti/„ Ra:>::::..fi?=".
GAS WATER HEATER
GAS EQUIPMENT+100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 50-121-,000M BTU
C�II�f:�k��l�f�1:� 714t
-x026 <
-
BOILER/REFRIG +1 ,750M BTU
'�`€PUN.F.i��A,_i�l'�I�Ii�I...1Ci1�1`�)2�i}-�- .. Q�Sagga
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
:
VENTILATING FANS
TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
rswi "V
GAS LOG
UNLISTED GAS APPLIANCE <400,000 BTU
USED APPLIANCE <400,000 BTU
IS D: L1AN_ k O:O O
AIR HANDLER <10,000c OOM
p
NOTE: MINIMUM PERMIT FEE IS $35.00
A, .... _w .d AA"
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x10.00
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
x20.00
x25.00
x 35.00
x 60.00
x 10.00
x10.00
x50.00
x10.00
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
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
=
-- -
25-,-00
r
1
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_ $
Spokane County Division of Buildings