1992, 10-06 Permit 92008404 App Mechanical FixturesMECHANICAL PERMIT" APPLICATION FORM
In-ror. ation Worksheet
JOB STREET ADDRESS: e k S SD (ko, , )' e•
CITY/STATE/ZIP: eAmkrlt)1.1 , cL 9'1 PARCEL NUMBER:
OWNER: o .-rk e:d\S� PHONE NUMBER: LV2 ' 50)1
MAILING ADDRESS:
•?-(-) 0
Co
(Street) (City/State) (Zip)
r CONTRACTOR: } C t � ,�1�Y.i�l C=. if F2 LICENSE NUMBER: - i="r f C.0 &. f `-3 I L4
MAILING ADDRESS:
PHONE NUMBER: (_5-Cq' G%'�?Cr-- g i I I
(-' -3 , -
r
(City/State) (Zp)
DESCRIPTION
(Street)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYST=MS)
.....................................
:WCODSTOVE ii43E
CAS. WATER
AT:>....... ..:............................
FR
GAS EQUIPMENT +100,000 BTU DUCTWORK)
EOILEPJREFRIG 1-100M BTU
OPP
SOILER/RE FRIG 501-1,000M BTU
BO!L ER P.EFRIG +1,750M BTU ' ..
HEAT PtiMP & AIR CONDITIONER 3-15TONS
EAT PUMP & AaR CO..DITiONER 15 30 T NS
"HEAT PUMP & AIR CONDITIONER 30-50 TONS --
VENTILATING FANS _ • .-.-.
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
................. ...... .
T'fP
CLOTH ES DRYER
:.:.:::::....................:................:....................:....:.
GAS-lz4E (,04 L L E .✓
'MISG I_AN OUS (NO3`COV R D S r-2
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPL€ANCE >400,000 BT1J
USED APPLIANCE <400,000 BTU
.................
USED APPLIANCE >400,,000: '
AIR HANDLER <10,000 CFM
AIR HANDLER >10000 CFA
NOTE: MINIMUM PERMIT FEE IS $35.00
�.t
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x10.00 =
„2-v
xlnnn _
x 12.00 =
x 15.00 =
x 1.00 =
x 1Z00 =
x
_ -
-
j
/0``"
SUBTOTAL
S ate+
PLUS: PROCESSING FEE
+ S 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= S �� of
SIGNATURE
Spokane County Division of Buildings