1993, 03-30 Permit App: 93001928 Mechanical Fixtures3 '!Y! Sty•j'; •. , .
MECHANICAL PERMIT AfG,CA'TION FORM , F
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OWNEr1:,. ; f/!�7!lZ ;1j`� .:T.7` Ver
MAILING AODRESS:
CONTRACTOR:
JOB STREET ADDRE S:�
CITY/STATE/ZIP::
PARCEL NUMBER:
PHONE NUMBER: c.
11,1
_ . (ZiP)
/ $// ZT7
PHONE NUMBER: ���-•�S'.�5�
MAILING ADDRESS:l�,p'
•a' t : ' ; ;` (Street)
1''*'•tt�;s
DESCRIPTION
ELECTRIC/DUCTWORK JSEPARATE SYSTEMS)
GASNOP Y�WY�ATEER H�E�A'2TER� s 1 4i��•A. ' 1 e $'€aa sM : op.: a 1'> ash air -
GAS EQUIPMENT +100.000 BTKi#:<,
C ASi EI4+I1: ( UT! ...
■OILER%REFRIG 1 100M STEP'
I.f�.
BOILERJREFRIG 501-1,000M fTU
BOILR/RErRIG +1.750M t3TU s'
(EA' i 'l `R O. ORMMFM.
vnS
HEAT PUMP & AIR CONDITIONEh.•3-15 TONS
HEAD; I tJr.4.X�cid t Ryii�a tvv
HEAT PUMP b AIR CONDITIONEI1 30-50 TONS
VENTILATING FANS •' `" "`'
•
TYPE 1 HOOD (PER 12'OR 12' PtN. OF HOOD)
torsi` ii bd .>}.,�;> <.<:t «z; xt .:. x4 ,:r.,
}CLOTHS DRYER ..... ... v.£.x`;€>€ass.<..:5.. °. y
�p1Nd#9"nihM:\:>+Y.. }:.;ae xF >::,h`:.`•:'Yq: '..�.�;Y.�; N�9<::X .. .....:
4::
GAS LOG ���� � '�
MISOKWI ati :(NOT;Att�1. F U .ttVyNl
UNLISTED GAS APPLIANCE:400 000 BTU
ULINS,f IS:. A$APPLIA'3Ct ~ bx,000 f3YU
USED APPLIANCE.c400.000 HTU
uStI A #1 ANOE$406(ft . NOW
AIR HARintie $1.6:6166':
AIR HANDLER <10.000 CFM
NOTE: MINIMUM PER
SIGNATURE
FkE is $35.00
t ,
,x Agar : s`
LICENSE NUMBER:
..f (Street) (City/Stet)
`MECHANICAL WORKSHEET/FEE SCHEbULE'�`"�;4�h
XEACH -
UNIT :''
NUMBER •
OF UNITS
•
x 10.00 ..
x 25.00
x 10.00 I:
x12.00.r'
it 15.00 ++
x20.60`iM
x 25.00
x 35.00 d :1
x 60.00 .. "I
x12.00 rn<�
x 20.00
x 25.00., 69
x 60.00 • .ii
x 10.00 •� r:,
x 10.00 w D
x 50.06 •: ;;
x 10.00 re
x10.00 Q:X'
x 10.00 am
x 10.00de.:4
x io.00% F
is( 50.o0t
xloo.00
x so.00
x100.00 •� ' `.
X12.00en:'`
x 15.00 + "�
• /O, ere.)
1+YcrZ v c.)
>vi
)�
s-?� l• rr
_ E-
•I
•
. i,,l.• •'.. Ii
y
SUBTOTAL
PLUS: PROCESSING FEE
+$ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=3
i'?"`' i
Spokane County Division of Buildings
West 1303 t3roadway Avenue Spokane, WA 99260 (509) 456-3675