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1993, 04-13 Permit App: 93002417 Mechanical Fixtures\A • b -1O4 D5i1 0.,0Qc Q \ MECHANICAL PERMIT APPLICATION FORM Lw U t Information Worksheet JOB STREET ADDRESS: eiAL( C 3 k) - GO/. k� 93-o qI1 asi 3 CITY/STATE/ZIP: OWNER: 6A -Ci € -'PA c) 7€ PHONE NUMBER: MAILING ADDRESS: ' 5A -(AA S ez,(cW - (Ud4` qL q2--4 - (Street) (City/State) (Zip) - CONTRACTOR: O (l c'Cnn ,,,, c( I4 ' LICENSE NUMBER: ((1- Vie ( Z PHONE NUMBER: MAILING ADDRESS:4777 l ` e• 1 (A/10 )1,0k Ci ed C ke-L'e s (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE RCEL NUMBER: DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) : ::.: :: v::ma•.v::.v::::.v.:v.:.:::.�...:..h.......{.vvv...v:......v.v..\.vv GAS WATER HEATER <f.1y••• • }!y • { r ? r r ion, `: v���s �.};�i'.•.!�4�::ua}r4tN�ix! V.`Fi.•�?;�;4!%::l::tk?�:�i•,�c,.i.a:,3o-nwa}•,.}'}:;•:••^••};•::v:. GAS EQUIPMENT +100,000 BTU DUCTWORK) {r :.•r:.v..s::.•y.:n:•: n•: r:v::.v v. r}::.w..;::,,,, :, / :: :\i {rAi:: v:::••:•. �jt t''* ; :: -::ktv Y'•'+'+1•Y \i " f ::.:::T-:.r:Ji. -: i:.o:::;•:::+�i':.,r �W"��+4'aa:aah''}:»: ' C;.w::,.::ac»xe:;:'R. BOILER/REFRIG 1-100M BTU t,?ti##..�;�.T.,v:.!'t.KV:V V!?�fc`ia:•:SuGG:::ao-:::, BOILER/REFRIG 501-1,000M BTU- `���'1..1:4:�!Z(;��'•.'�€�.i,;x7!:ti�tlai�5:7�y:�r�'11����Y�::L?<�,,,.•r`::•w:kr,:V,,.uaa.:u.:•:✓.;: BOILER/REFRIG +1,750M BTU 2:•;:::.Y.:•::.,.}::::{.{:;}•::::<.:{v�,r}v}••,•:;>,yv�.,,: N:kry�•,•: <.f::..:i:�yr�y; ::`:}:,::.:�:y.:fyr�.<:.;:..nK.:,,,y.�}t.}c:;:.}::.::t«:.};•:;}}:;;::: T UMP SX AIR,�cOND1TIOl' 4?4V.'44.4•,'4xfT �x?r kw ..:::r:;r:va::;• HEAT PUMP & AIR CONDITIONER 3-15 TONS ,af�a ,...x.„:„.•••••,:•••••••••-•• Ate t:}.,,:.wuw•w�:t�x�.'a&:,��• E, HEAT PUMP. &:.Aw,R CONDITIONER 30-50 TONS n;%.•:�.-:i:T:riiY:- VENTILATING FANS ;y.:..; .{:S:N „ia•:<.: o°j.}} X•;•• rF;w;:•�c-,,,,::•{ :m•.,r:::; ;.•:.1:'•'•{..•:>. • :::}:::u:a}:::.:.,}..,.:a:�,•:�u;:;afr.,a:,•:sw„r:xa• .. •• ..;x'� ,ac;',•�'.wZhic4.c4w TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) :wa:J,{;v. . 7C;Y.;:;, ::::• X i 1X FM• {v:W.,.;:ry• .;fi.•.•:}:viv.•:.w:::::::..;v4}.+.;;5:.,:,.�•: i:,;ri.'•i`•::i:.v. hi-' iti{;W:4%i;i•..v.i:.::'.::-:;1 CLOTHES DRYER .................................. GAS LOG UNLISTEDrGAS APPLIANCEF<400,000 BTU USED APPLIANCE <400,000 BTU AIR HANDLER <10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE L,1_) - 4 c CQ{ (zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = / x10.00= lO--- 1 x 12.00 / 2_--- x 15.00 = x *-7x ,,-. 1.00 = x12.00 = x20.00 = x 25.00 = x35.00 = 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 = x10.00 = x 10.00 = x10.00 = x10.00 = x 10.00 = x 50.00 = x100.00 = x 50.00 = "__. •-- / -2.--- • ; x100.00 = x 12.00 = x 15.00 = SUBTOTAL $ PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =$ 6,1 Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675