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1991, 11-15 Permit App: 91007898 Mechanical Fixtures
Cl H1Vce JOB STREET ADDRESS: Lb��ct I` tk, 1 D (^_`;-) C '(o 1 MECHANICAL PERMIT APPLICATION FORM O(C H fl -C 0 A V Information Worksheet ( ` CITY/STATE/ZIP: , \1.. PARCEL NUMBER: OWNER: \Q-A\ PHONE NUMBER: 43VC0 MAILING ADDRESS: CONTRACTOR: (Street) (City/State) )FY V\C€ _LICENSE NUMBER: PHONE NUMBER: MAILING ADDRESS: •��3� NU\\6`(\ DESCRIPTION (Zip) AKTh'‘' (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) •W OpSYO E1tNSi=Rx 1.f;.An• 4}i%{:%{:ii GAS WATER HEATER GAS EQUIPMENT +100,000 BTU DUCTWORK) i : dk. _.. :}:t?;{:{:.'•,:air s; BOILER/REFRIG 1-100M BTU .B.Q�ITyr j��+ 1 �y n/,� '�.iy�[{}`f•WSy Yr%•ii,i}:iii:}i'r:•::: Nr iw;�n�)?:R1�6:�,V.�*-.�.V.V.�:�Y,r•,. { }..:.:i:: v::.;.... . ...u.ww,,.•:ow::oi{.•wi{.ia}:w:}.,}. Svi'sw ��7aobRi•;»%.yr}: }:4:�:.:::ti;;:. BOILER/REFRIG 501-1,000M BTU B:Qat�'RICA:fit=:f31��`��"�A'�0:0�1<`iXSQf •.�. BOILER/REFRIG +1,750M .BTU 'H EAS`>PU.M.P &`'ACR::>C:Of T .C3..: :.:::. HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT P. JMP 8':AI.R CONp1TIONEI `i5. 3b TONS :.:.:.... n...:v.. r. rn.. rnv..w»::rr.•.:•r:.v ri.v....•. :rrxNr.,.:mx}Wr .y}}: k ..... .: HEAT PUMP & AIR CONDITIONER 30-50 TONS 'LJ C:71'."•Tt � i+`l'►`I �'30�%ii�f'n•it+'n Li'rw*r!Lea �:y .+• rv.o;>..:+ i.:....v�c •::.: ':::::}:;i:•':<:: VENTILATING FANS EYAPORATIYE COC•LERS....x :�V:.•w< ; :y :•••• • •::>:> TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) CLOTHES DRYER GAS LOG MS,G LIAANEOUS (.NQ .10:OV .R. [ ::C+.('*SE1N.H.RE UNLISTED GAS APPLIANCE <400,000 BTU ULINS.T,ED GAS APP.LIANCE�4QQ,odd``BTU USED APPLIANCE <400,000 BTU •USE4 AP:PLUNC.E `:<:40:0'0001BTU>{ ><> AIR HANDLER <10,000 CFM AIR':HANDLER >:10 000'.CFM BUILDING & SAFETY NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE A\ (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x25.00= x 10.00 = x12.00 = x 15.00 = x 1.00 = x 12.00 = x 20.00 = `x 25.00 = x 35.00 = x 60.00 = x 12.00 = x 20.00 = x 25.00 x 35.00 = x 60.00 = x 10.00 = x 10.00 = x 50.00 = x 10.00 = x 10.00 = x10.00 = x 10.00 = x 10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = • id -00 1"A- CO � . oc \ . 00 ` '. SUBTOTAL $ \ ,CO PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ 3cj . Spokane County Division of Buildings WASt 1qr1.'2 Rrnariulav Aveni ie Cnnl,nno %A/A ofloan icnnx ACC oe-7e