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1991, 11-19 Permit App: 91008004 Mechanical Fixturesv15`Aa_ 356C,10 CSOg f,15I MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: l�s'/1:-/-2/K)\//27-70 CITY/STATE/ZIP:j/` O/ /-9-11J67.-1- PARCEL NUMBER: OWNER: 1)/(?/_) / /--/4I PHONE NUMBER: MAILING ADDRESS: CIS%(t, '�'-) 91_ cooLi Neck N o L•I a`! ° CONTRACTOR: R & (Street) (City/State) R HEATING & A/C, INC. MAILING ADDRESS: DESCRIPTION E. 1723 Francis (Street) LICENSE NUMBER: BRHEAA*106BW PHONE NUMBER: 484-1405 Spokane (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) ?. iii: Ctii: ,'v: •isi}':t:ry....%ifiti-{'r'r'.ii':::iii:?< ::::Yi: ::i S ::: xrvw::WATER. :;v ;vnv.: r.:v�... .: v .. r. .; .. .?..8q :.:: .:.?::.-f:ivb:n'?:•;?:•::::rte:•:: •: ..:: n;;:?::::: ::::::: p:::: GAS WATER HEATER yM:ro.....::{:: ;r.,v,?{::nin;•t;:i>: ii: 1.1 lfi•.:#:;;;:!iF1FjW/V i7 t�F#,e�lt .:..r......wr..r:::rxiirx•>:•:???•:i::t8i::-:i GAS EQUIPMENT +100,000 BTU DUCTWORK) ..::>i.>:::,v:..,...y,,vrrv,::..,,;..:..:•�.•-:::::..:,9:;:�i.'•�s•.`:,`•:.»;:k;:::.;;>.:;;"/.,„r•/`.7,Y.`,',-`; BOILER/REFRIG :1-100M BTU BOILER/REFRIG; 501-1,000M BTU YnWr:iiHr:vr. y} ♦ ...Y.+.... vA\W.wGrorrSW vTivMu+i�.f0.•.:v�wrli<-+0.:t•Jvs�e.-0v:fi BOILER/REFRIG�*1 750M -BTU •.ro•: n..y. . {�{���JroJ• yio~t�,^yE�:,'^;�,.:.nr.�:.,�.�.,.yr:: - ,; ?,v?,;;::.i;;:.;:?r .i: HEAT:PUMP S�4AIRCONDITIONER 3-15 TONS HEAT -PUMP & AIRtCONDITIONER 30=50,TONS ?:.:.., y r�1rj/y, nr:.•,ny ,a .�:: .Y:y,• � r{k+r�7}f��'.:�vj{.�.'.��...;�•;r foc:.r: ,►��yr{S,t :?y;;,::.:::.:•i;:r.::.t A."Wf •• `yCIVI .bifitr:A4+nw"' E41: .11.7 ,;„; wrr. rrw.?::hti:i VENTILATING, FANS moo, y,�yF� +:ar+tr: .r+i: x-:. tom..•:? - :. jS'(C.ai.wE "'��5�`:�Y��F? �yt�. cI3✓�'E'"°'�w � !,:'�r':i.: r w? I "' XivAh tarrW x: i TYPE 1 HOOD"(PERi12'- OR 12' PTN. OF HOOD) /}�/�yityyer? .�:..rr:,M::�:r,:kem,?'�;yy r,<. x•^ix�:>.:•;:><:::v:..::"::•;. .. TR:. r , . in .. //SIj'Wir$' � n':•. v 1 }� �{L�.;i,:}.: Y .ir '� i r i7�fzoG4[S:h' Y r.:G�%x r. n4 .0 G CLOTHESDRYER,'�_3, aYaw.< .Ri�F3,:Qa EVA �•..r<: ,yy:y..:.y � „ .:pro x.: GAS LOG •:0::li0.\ AS:v ��i:.' 43{•iv� •5}?i{�:$SAl\iiv:. iYSb:M'3. ...• grr M :rvrx. a.,�,•.a„,,,...M�...{WMME'•n4iiv'. UNLISTED GAS APPLIANCE <400,000 BTU R;;:y.iys;oy. �,�; .•.,�yyp•:: ; :,go.:.i+.,w:•..:::,,cg4,,;.�.:.r::.:>•:y:.;y::,w, x,,; .... ....y,.i:.. :v,cAr 7".. a i 'w;iSdca3a"."�a WAV :a ,.;?� ,�:: :.:. f i:;i:::: USED APPUANCE <400,000 BTU AIR HANDLER <10,000 CFM • NOTE: MINIMUM PERMIT FEE IS $35.00 (Zip) WA 99207 (ZiP) NUMBER OF UNITS d} YOW: X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x 10.00 = x12.00 = x 15.00 = x 1.00 = x12.00= x20.00 = x25.00 = x3500_: x 60.00 : = :. x 1Z00,:= x 20.00:'- 'x25.00 . a�, x 35.00. _ x 6000 ;=, x1000 ,= x10.00 = x50.00 = x10.00 = x1000 `= x10.00 = x 10.00 = x10.00 = x 50.00 = X100.00 = x 50.00 = / /,-,c.( ) r / . Cc' is x100.00 = x 12.00 = x 15.00 = SUBTOTAL $ j_; _; PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ `'f,. C/-' SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675