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1992, 09-14 Permit App: 92007572 Heating EquipmentMECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: 'Z/J YV Ua C71 mc' 1 h CITY/STATE/ZIP: Pc 1: ah PARCEL NUMBER: x,5/7 OWNER: C'•Ai`G �/� PHONE NUMBER: MAILING ADDRESS: 13 ! / (Street) (City/State) (Zip) CONTRACTOR: C o m f-041 LICENSE NUMBER: o rn 1- - o ►_ PHONE NUMBER:_- 926 - 2 ).1 MAILING ADDRESS: Il I tot, 1 %o`h c,�y r7cl ids (Street) (City/State) _ (zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X.EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) x 10.00 = x 25.00 - GAS WATER HEATER x 10.00 - :;1?V!A!lre�R:l::1d1�iV•.V.V�.ii.�ttt.!4J. #:......:...:..�.r...r::rr:.r..,r...w,Y.t.r..,r..:nr.,•..:r..�..,r:a::::::..kt•:.: r.:�.,t•:r:.t•:r. tiSxv:....v}? .tw:a::r. r.{r,�:. GAS EQUIPMENT +100,000 BTU DUCTWORK) - /. X12.00 = x.15.00 = ... �.: ..: .... .,:::}}•+?{{x{:.w::t.:v:8::y}Y.::xn•.yrv-.•.w{;tt•:.vvyx:::u :v}{^},;t.}.;: jijq}}:•Si4P'':n "ui '`Ett4:?':::^:}};{{.}};.xfi�v v; •�A�p.:f'.:i`t.�}. A��U�.'� ' :��.} -< t:�tt,�:>�;.�:>.�;,�{3 <�.},:�}::�..:.::: ftt•::::::.v:.tt{v.,•x:.v:.tt•.:v: �.tM1 .v.{tvt,av,a�n,x{i}:: Y.t{tvCv:{•:tii�ri{titin}L•.,wmvM,M�iY:]\ra,K,•.{wxM4:,vv: x 1.00 . BOILER/REFRIG 1-100M BTU x.12.00 _ Yn}:::?,.. .,;,::.. ;.K^'}y:.„:,t t:. w,}•.w.,:v..};} }k„};,,h;;>...,>,}}t .}}::^};; .K:?.;,}>:C•>. {ff io.,a.::::::.,.:.,..,.,t.:rr::}.,:w..•r.,,•.,�.•::.,t•.,•:r::h...•r:.w;rh•.,,,•.t•.,S.t•R•.wa\�ftrh:.,:ws�t$}�,.hw„•,Y.,?a,t,•.r:f .ttt,•::: x 20.00 = BOILER/REFRIG 501-1,000M BTU x25.00 =. p.!l.Y: t{::.iy:: ?: x: }•:: x:::.}•: r: nv}t;rv/.tr:+f.{.vtnx{{�{: •.v.}:}r: }v;rir?n•. ry {tf vnx.::•:::. .. x 35.00 .. BOILER/REFRIG +1,750M BTU x 60.00 = x 1200 _ HEAT PUMP & AIR CONDITIONER.3-15 TONS x 20.00. r.:•s:::..y:::::.tw:.w:.v.}y::.M1,v,.yvny:w x�;w.t}vtx:xvvm:.vvxtv}x:}tvxr.�vx.:vy F f ?:Y••••• ,••••••••• t�..�#'�:t'�lt�C':�:�lXtr�t�.C�i�•t't'tC�t�:� �.=>a`�:t�<'l'�1�� r..wh:�:?:�:> hv,.•.,t•:h•:.,t,+,,,,•.,.:.,.vw..M1„tw.ta,.,:.a.,V.,t,..,xt.,,,...wr.,,,w.,,. aw.wwwvwxatiwawn„,,,,.•:.»ixxw.,S.xv:x. - _ . -.X25.�0 . HEAT PUMP. & AIR CONDITIONER 30-50 TONS x 35:00 w:N{r.•{,4,.:xtr:{{.•rlrrirrrHrw}•{xrrN•rrx{x:rrn:}•nvrr{rd::im::.�;:lw:�•yi{rtrr.:{rr•: `: f^: r•{}:: eK+.:b:{i x 60.00 = ' VENTILATING FANS x 10.00 w+?•:...:.yw.,;,•rt..:.?.+•w.:s::{t{;:{.};.}l};:kh?.th:?<r::r;S^:':m}};•X•'.•..^.vtavrs2}:r.:::t•::}:..r.:.: i•:::.}:::yy�:{:r :•::.vj.�::�•Nlvtt:Yr �1c t .�y�t�•. � 4 % l[' S hxx }`} {{{{ ?' :ii:�$rt? •4i5C:ti::r::::i`iiii ��!'\i�.�..,.�!1T.•4::Y.�•:ti7•L�.F:}47}}.-::._::}:v:..: Tt ?'2 f ;c:.•yfn•:?..: .... : ..:.,-htii}t:.'i:{:CC{n`3-i:�ivr.Ci.4:t4:tN.•iG:t+rvi: t-.•r'f.•..tvf.•::.. r.•.v:::: • • • v:::::: v.•.v:::: mvvxvv w.v .•xr •:, w.•.,vvv:aaw,vnt•.v ... . .. x 10.00 # - - TYPE I HOOD (PER 12' OR 12' ,PTN. OF HOOD) x 50:00 = - t:-} v�Y:}:Yi{ii: r:::tri:,t}}}{::.4,`}}}}3t}}:•`:r.:vw:ryvr,.:•:r�:i::{ix•}:Q:M:{.yv.:}:• ..\....?AYtn•}r}}:•:{•}}:,}}L:i'.'•}:ir/.:r}:i:::''•j'•itPvr: J:::ri4Y.i'ir,:{i::?•}:Nii:?iii N..'l ��{:i rv; n....}: }::: •hy ..; .:.? :r•:; ...�}.: ... v:::f �. t:. .v.fv::: w::::::: ::'I'X... .:.I.::.:.:t%t.:'.:::?:::�•. r' �}.f:.�;.,.:.�:::::..}:::.}:v:.:::.::r:.:}:.:f::::::?.::.}»>}:.::.:?-}:: .,..:.:::::}}};;-v:::n:w.vx,:wnv.,4..4:i{ti t=:?::•••v:;'': rl.v., .v\•.w.n,•.:.v:.w.v.h'�.i'rxvva..vrw.w:::.vr:::: rn6. CLOTHES DRYER x 10.00 x 10.00 = - .. ::::.:t•}}}:•}::.,•:>:..,.:....r. t,}:.,.:.,.t:.:-::..... t ,: .. :... a:::}}}}}}}::}}:?,.:::,._:::::.:.::..•::::..,.•:.:.,t,,.,, r....,.:«r.,:ti •: •:•.tr::.t:,::.::...t•.w:.,:r: ::•::}x:}f}:::•}.}:•::•: x 10.00 — -. .... GAS LOG ir?>.,-:::}.,;.,.::;:.>...:}:.::::..r.,.:{r{:.,.,:<o,?;:y,.,:r:.;.,r:..w:{:.}.r::: :::;::..::.. ::;r{:m:rr :.�{n.:,;v:?; };:t,{.;.r• 1Vtt+aGBLi Ai�1CiI (f” C{3(?iC)tYVi< <r>« x 10.00 ._ x 10.00 s UNLISTED GAS APPLIANCE <400,000 BTU x 50.00 = x100.00 - USED APPLIANCE <400,000 BTU x 50.00 = .......:......::.}:::........ :::.:.:_:::. x1 00.00 AIR HANDLER <10,000 CFM x 12.00 - `v ? 1 _. x 5.00 _ NOTE: MINIMUM PERMIT FEE IS $35.00 SUBTOTAL $ PLUS: PROCESSING FEE +$ 25.00 EQUALS: TOTAL PERMIT FEE DUE =$ SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675