1993, 05-13 Permit App: 93003216 Mechanical FixturesMECI IANICAL,I'EIlMI 1" AI'I'LICA f 101\1 17011M
Informallon Worksheet
JOU STREET ADDRESS: • //: "' U Lo '
TR
CITY/STATEIZIP: n 79,20e. PAflCEL NUMBE11:
OWNER:
3_.3-2.1(0.,..
30�
MAILING ADDRESS: ,¢-a-•�
CONTRACTOR:
PHONE NUMUE11: `�,oZ�•- Yjl
(Street) (COY/Stale)
MAILING ADDRESS:
J/..__
(Street)
LICENSE NUMBER:
PHONE NUMI3E11:
��-- LA -'CL.
(Cily/State)
(Zip)
• 79,112
(Zip)
MECI IANICAL WORKSI IEE WEE SCIIEDULE
NUMUEII X EACII
OF UNI t S UNIT
x10.00 s
DESCRIPTION
ELECTRIC/DUCTWORI( (SEPARATE SYSTEMS)
GAS WATE11 HEAT -Ell
0.100 uirivigmm.Ot.,Q.0. I..)(INGLUuL
GAS EQUIPMENT +100,0 .00 U
1 U DUCTWORKKtMaI'ii C,S .p. t l:1.
•
BOILER/11EFRIG 1-100M 131U
<uol i 1,ht r lid o;i - OoM ii r ,: .
UOILEI7lREFf11G 501-1,000M 131U
rr f� � � �i; -►: is i ►nc�d i 1 r� o f rj
BOILER/REFRIG + 1 ,750M
D A i PUMP;.. Alrl UQNf I;1 italtlt n o . I...
HEAT PUMP & ARI CONDU IONEIT 3-15 TONS
HEAT PUMP & A111 CONDITIONE11 30-50 TONS
1
1
}
puMifs tri o i fqN +p i. 7
VENTILATING PANS
1!Af Vii;#A3IV OooLt,�a
TYPE I HOOD (PER 12' Oft 12' PIN.OF 1100D)
•
CLOTIIES UrIYEf1
. GAS LOG •
................• t. i+ v k i sEVcii:
UNLISTEDGAS APPLIANCE <400,000 UTU
rULIU$1b IIS APpijAUC >4 U c ,jd
USED APPLIANCE <400,000 g I u •
I:JS.Ef.1 APPL1A IOE � IQO,0t E
AIR I IANULER <10,000 CFM
•
NOPE: MINIMUM PE11MIr FEE IS $35.00
SIGNATURE �,
SUBiotAL
x 25.00
x 10.00
x 12.00
x 15.00
x 1.00
x 12.00
x 20.00
x 25.00
x 35.00
x 60.00
x 12.00 ter
x 20.00 e
x 25.00
x 35.00 ft
x 60.00 el
X 10.00 El
X 10.00 e
x 50.00 r
X 10.00
X 10
10.00 PI
x 10.00 en
X 1 0. 00 Et
X 10.00 r
x 60.00 ti
x100.00 a
x 50.00 ft
x100.00 eg
x 12.00 d'.
x 16.00 2.
am
en
ter
PLUS: Pf1OCESSING FEE
EQUALS: TOTAL FERMI F
PEE DUE
Spokane County Division of Buildings
„West 1303 f3roadway Avenue Spokane, WA 99260 (509) 45G-3675,
ft AMOUNT'
/O
$. 3S-
+ $ 25.00