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1991, 12-03 Permit App: 91008321 Lawn SprinklerJOB STREET ADDRESS: MECHANICAL PERMIT APPLICATION FORM Information Worksheet CITY/STATE/ZIP: PARCEL NUMBER: OWNER: PHONE NUMBER: MAILING ADDRESS: (Street) (CitylState) CONTRACTOR: LICENSE NUMBER: PHONE NUMBER: MAILING ADDRESS: (Zip) DFSCAIPTION (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE (Zip) NUMBER X EACH OF iJNfTS UNIT - AMOUNT T ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) A'WO.»STO'VIT GAS WATER HEATER SAS:. 1�■! : } {fr�y.WW�!�����i::Y.: },:•:]i{i.. QUI k . YYE rtr :- :: . l..l.:::3 A... im.:.... p:�"}�., .-� ..:'�.�.:.... .... x�• �'��uh GAS EQUIPMENT +100,000 BTU DUCTWORK) :GAS PIPIN 3 &OUTL ;u BOILER/REFRIG 1-100M BTU ,J.v� tIrv, J�e.��M.}::::.:.- .. ri:Lv..�','i�-:J-�i.S�i4 BOILER/REFRIG 501-1,000M BTU BOILERIREF IIG 1,0001 1,750M BTU - BOILER/REFRIG +1,750M BTU IEA 7PUMPBAIhONDt701�1ER0-S TO! HEAT PUMP & AIR CONDITIONER 3-15-- TONS HEAT xM0A43GOND �O0WO HEAT .n S � .,.�,...... .....:'.>' .:.�. PUMP & AIR CONDITIONER 50-50 TONS VENTILATING FANS TYPE I H000 (PER 12' OR 12' PTN. OF HOOD) CLOTHES DRYER GAS LOG ................ .. MISCELLANEOUS (NOT COVERED ELSEWI4ER UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED GAS APPLIANCE>400,000 BTU USED APPLIANCE <400.000 BTU .USED APPLIANCE >40%000 BTU AIR HANDLER <10,000 CFM AIR HANDLER >10,000 CFM x 10.00 = x25.00 = 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 = x 20.00 = x 25.00 = x 35.00 = x60.00 = x 10.00 x 10.00 = x 50.00 = x �n.nn = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x 50.00 = x100.00 = x50.00 = x100.00 = x 12.00 = x 15.00 = ry-.-...... ..:i • NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE e4{ Ob.) SUBTOTAL PLUS: PROCESSING FEE 25.00 EQUALS: TOTAL PERMIT FEE DUE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 09 5 LA (:)1119 Cf° UMBING 1gppc(LE.S JOB STREET ADDRESS: E, I /1 /.J CITY/STAT IP: �r f i Z PERMAPPLICATION FORM nformation Works eet ACLoe tar? d.CCLn G19OD,fv PARCEL NUMBER: OWNER: =7 I t'()Oil eu 6a.n' MAILING ADG-c ESS: Sxi r)1 01S DESCRIPTION • KITCHEN SINKS L �i�V7 '-�I�',ayJ�CZ7�7ry34 GARBAGE DISPOS Rte' T•. x-,o-:ix;..,�w•.>iawa2`�„"�io��» S�k43f -� . '�,-� i � �• ; < ; DRINKING FOUNTAIN. t NUMBER OF UNITS «,- X EACH 3• - UNIT = AMOUNT x 6./0/0 = X6 00 = x6.00 = x 6.00 = x6.00= x-6.00 = 6./00 = X ..xs 00 =-- ...ia. .a -- 1 .. . . • ' ' '', • 9 _..:k t,-+ �� r'. r.-, _.Y* '.f. , sem'000.,!�` //�,� 1-= ' i .a �.. r.�'a , i .-.,•,..- , . +•Lik.NOt56I l"ty +4 I R+F "iii;iii;r 1;l fx'�C i b , .,1t. • .JY . t� '� , , -17.7':"..f• , 7, r i � /� 1. x-06 o r t "` :_ S yy } < t r.,„„ x`6.00 ' . x 6.00 ,, q:- ,....-11-- - o _ _ ) 3::,,C, ti ", •• '41--x ~a ... . SUBTOTAL ,,,: '-'7:;,,. i'' ,-x .•, S , PLUS: PROCESSING FEE 4 - -• + S -- -=- 25.00 :' EQUALS: TOTAL PERMIT '• FEE DUE _ $'•;:•' /, 00 Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675