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1993, 03-04 Permit App: 93001237 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: � ( ' 7 CITYCITY/STATE/ZIP:`19aP: c��o cam„ Q � 1 .1, b (c PARCEL NUMBER: OWNER: PHONE NUMBER: C? -1. f MAILING ADDRESS: 7 I(Street) (City/State) ) CONTRACTOR: irk ti_�..r i I t.-�` ,,-. f-c' r^ tom` LICENSE NUMBER: ail' -- �- C -i SZ' PHONE NUMBER: q� 1 °-�- c -- / MAILING ADDRESS: L- 1 t (c t (c .�'1 o,d A<w �crF�-4 Y - ��{� iV �� C. 1299. (Street) (City/S te) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) ;N:POPST.P.MEO.NSEgra!!!!::!!!!';'!!!gtaellignigiaa GAS WATER HEATER PM-.I.'I.`�`�. GAS EQUIPMENT +100,000 BTU DUCTWORK) BOILER/REFRIG 1-100M BTU 41411117ff-. i7F:: .:T.".:`" :l!Ffaiit7 BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG +1,750M BTU .')!'.PUMP, ts< �►IECOPIV11014... i►- (x�.;._<::, HEAT PUMP & AIR CONDITIONER 3-15 TONS ,F,tu .. P>&tAIR;. DIT .N'ER€"1 O> & >f > HEAT PUMP & AIR CONDITIONER 30-50 TONS �.. T I UMP &- AtIR CON ITIONE +S0 TONS VENTILATING FANS :;: ;X-. TYPE 1 HOOD (PER 12' ORI 1�2'RPTN. OF HOOD) •.....:.........:..:.:.....::..:... CLOTHES DRYER •.:Y}L, n.@, i • s�vvcc�� :tiff?i ..:.''o�..�r.'-.q•.�:•..'.•.�.w'��.�.-.i.�-'<k��s...�•�":'F..::,d...<:...:u`v'w$":::^�::<>-...,v.........:.:.... v :.. ..r4:.aa✓Ai~ i"i'G•y'�:::::. .c........... GAS LOG !ELS- Mai UNLISTED GAS APPLIANCE <400,000 BTU USED APPLIANCE <400,000 BTU USED APPUANOE #. AIR HANDLER <10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x10.00 = x12.00 = 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 = x10.00 = x 10.00 = x 10.00 = x 10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x SUBTOTAL $ lac, PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE �i = $ //. GD Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675