The URL can be used to link to this page

Home My WebLink About1991, 11-01 Permit App: 91007501 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: //15'i CITY/STATE/ZIP: 5M7#'? e,4/A- ?9Z7 PARCEL NUMBER: OWNER: C/� .&/.'F•01 Amy. sre - PHONE NUMBER: 9' 2.l -)-2' �- 6 MAILING ADDRESS: ////.e 5"/". - 4 6 �// (Street) , (City/State) (Zip) CONTRACTOR: A• ,gi'! ¢,1" SG LICENSE NUMBER: 1.,E z 'A El. /D1 a -7/v ,!PHONE CNUMBER: 7 2 MAILING ADDRESS: `/I/$/ `u' t-' r? �v ;o C/i'A1 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) • spay `: Sys':;:szv}••::i:a# ,t::-::.:}:. c,}:}::F GASWATER HEATER:::.:.............................................:..:.................... GAS EQUIPMENT+100,000 BTU DUCTWORK) S A��.:PIPt�.�C€-•IR:A?�1��' � "::�:i.:;i.:".x�<;: }�:.�_.;::_:;:.}r}}}:}:rii«.:, v...4}n.. } i••w+h} ..v�., ..••':v:::�:'-.}::::i':... x.:..:.v:hh4::.{.vil`Cilfn 4.i::..: :v:::.:-}::.�:4h •'.v. BOILER/REFRIG 1-100M BTU f4+M�iii4i.7:';K�#.fwi�??:# Yti� EN�n:`�;#;�:;•`:::::;'.': BOILER/REFRIG 501-1,000M BTU BOILER/FRIG +1, 144"4-1. HEAT PUMP 8� AIR CONDITIONER 3-15 TONS ..}: nvv y �:.}vivvvvvalvw.yvxx: ::• ¢. � plC� ,o-':::'`:•:::3 -So- '^::Y::]: rix:::c}}ii:•:�:ivrhatF:>i n:.. '-.vCrh#:•j}.; V 7M REBTU .. tiv: x}::ivviv: i}i:iiiii}}::4:: }i:: is }i::�:}: }iivw:ii•}- v:•.VR.:i::hh ih: avlrvinanivv. HEAT PUMP & AIR CONDITIONER 30-50 TONS `TEUNOWIRIONIVOIMMEgt. .x• VENTILATING FANS rit}•:,.;'.: x•::h,�:...w:•}:.:x:•:.i.:;..-}::.::a:.;•};x.i:•`:•}x.x•::::ti:}1:yam:• v Mlh�"y }i�a TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) ,.,.�((��Yx�y�.;.:}ya•:,•:.y:.:}•: Y: .i:;p.:::}t%}'ti{:,; >�• 1,:::kw::s$;,}•.• i.»,: �. t,Ai::.. ./ y��5 .'1. H : i ETi-0v'.,ll,.a..'P:ri:.<i:i.'F y:; .: 4 ::>?i`4: i.?.+..if •t,{�^v'i •:4 : � ii,:,.:iy.::. , .: ? 2 �i.- •::7'hvW:.v.:•.^.a•'x��•.-':4:•.:vivi..3:::•�iiti8;•}::;•h':}iii Y::l..:•ii:}:•iiRi}iiF:::•�:f'�:vi.'1.AYCi-:. . . •.-S:+�*`.{�.::i:;.Ea•}v�,;•`:;•a,�,. CLOTHES DRYER t i...t M,.;:x• :u,.:!•J.FC;: ' iric:xi.:}:: i.}:•}::li:. }ty i:::• :::::; :::p:+F :• s ;;:.'•. • ; :�a;"-°'}; . .i fi } � �{} fi•:. fa': •w1.••'.}: •>. J.#`tiii}. :i :`Y }{. ,.'�•.}:�i}iv �;;. :v:La�'• vr,.. ihv\:.riwrht�}:::v:}t thKv ih:}:tv}wv::tih:h{•y-iC:�{ih,:i'J•}liR:if4:?:i..f:':;:^3,�,�a'2'.;A.,:#ifs`-.�.a: w•.` :.{.hi'••'•••`3. GAS LOG xv.Avw.v::::: nvvvvvvv:::•:.i,v,,`l�!T.��*A�1�!!R!:}1TfY':;9:?-r::};},:i'}•'.. UN"USTED GAS APPLIANCE <400,000 BTU •�.U.r...}vvyn:vvy.}y::::i rv:::i �"�,:fiv,6,vvi:: ' .$j' Y .;i::ir:iy:.ngy:;.v:::i%iYii:. I.y].;�wry:�� ]y��`J •:tr:': }}jii:�ti::ititi: r::�}W. :T:;1lR�•'••••:•hvAl vlRi::'TR}'Fnf '{S:t::r,:,}iC'}i::�::}:'} Y�: iw:.....:•.::.:.r:hu:.,.r........:..:,w:.t,:.::-.::.::.:.:•.:•:::.:x:.:..:::::.::::::,•::•:.�• ::.::...•:.a.: .:.�:.o-:: f::::::.:•:i-:. USED APPUANCE <400,000 BTU y,!YL }N+•i' .x.lnvhvxvn•: i}r: y.L:m nx:.v:::.•nw::.v:.vyiiv::r:.:::.xv:::::::nv::.v:.: �.::i+�:�:>.•i.`:..... .li:i•:. NOTE MINIMUM PERMIT FEE IS $35.00 NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x10.00 = x12.00 = x 15.00 = x 1.00 = x12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 10.00 = x 10.00 = x50.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x 50.00 = X100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = 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