1992, 02-12 Permit App: 92000766 Gas Log, PipingMECHANICAL R'MIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS:
Ll 7 0
CITY/STATE21P: S pz>K 1A-�qdz) PARCEL NUMBER:
OWNER: C SCI I p0c) I PHONE NUMBER:-- q -d- to 706o
MAILING ADDRESS:
.................
(Street)
(City/State)
X 12.00 =
(zip)
CONTRACTOR:-,--7,,�-,,
GAS E UIP ENT+100,OOO BTU DUCTWORK)
. .........
LICENSE NUM BER:
C)
x 15.00 =
PHONE NUMBER: -L�.)..,'.`c,;
C;-") L,
MAILING ADDRESS:
x 1.00
0-2
(Street)
(City/State)
(zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
-------------- ......
........... .......
............... ---- ..............
---- ------- ................... ............
NUMBER.
X EACH
DESCRIPTION
OF UNITS
UNIT
=AMOUNT
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
-----------
BQ11131?1=FRiG.=13001 7011A X
x 10.00,
x 35.00
V DS.0VT/.INS
..........
x 25.00
-x 60.00'-.
GAS WATER HEATER
x 10.00
.... .. . ..
EQUIPMENTCAS ...................... .. . ....
-6".
x 12.00
HEAT PUMP & AIR CONDITIONER 3-15 TONS'
.................
X 12.00 =
GAS E UIP ENT+100,OOO BTU DUCTWORK)
. .........
x 15.00 =
..... ......... . . . . . . ... ............ - ....
G,4S PIPING EA OUTL.... . .. ]�: - - - ---------- -- ---
------------
x 1.00
0-2
BOILER/REFRIG 1-100M BTU'
x 12.00
-------------- ......
........... .......
............... ---- ..............
---- ------- ................... ............
x 20.00
BOILER/REFRIG 501-1,000M BTU ...
x 25.00
-----------
BQ11131?1=FRiG.=13001 7011A X
x 35.00
BOILERIREFRIG +1,750M BTU-
-x 60.00'-.
x 12.00
HEAT PUMP & AIR CONDITIONER 3-15 TONS'
x 20.00
---- ----
HSAT PUMP AIR NDIT 0
. ... ... ... ..... ------
x 25.00.-=
HEAT PUMP & AIR CONDITIONER 30-50 TONS
x 35.00
........ ..
EA. ITU NE . .. T .. .......
x 60.00
VENTILATING FANS
x 10.00
.......... .... .......
,.-EVAPORAT.A.—C 00 PF -- - ------ - --
.. ... .... . . ............
....... .......... . .....
x 10.00
(PER 2'...913 1-.2-'-PTN....0F HOOD)
x 50.00
.T.YP.+E-I...HOOD ... . .. .. ....... ................
...... . . .. ....... ............... ......
x 10.00
.,",LOTH ES DRYER
x 10.00.
............... -----
...........
... . . .. .
...... .. .............. ........
x 10.00
GAS Lo's
x 10. 00
.--:i . . . . . . . . . . . . . . . . . . . .. . . .
.. ST Af,
.. .......... .. . .. ..........
J
q
..............
AIR HANDLER <10,000 C
-Ui\,! PERMIT FEE !S $135.00
E Q U AL T 0 T AL EF1,,V. I T
Si GN F U R
Spokahe County Division of Buidngs