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1992, 09-18 Permit App: 92007811 Mechanical Fixtures
L, & !V� 11,4111U lL r citi � i ArrLIUM I IUM rv�--`VI �7 • b�k i% ► Oh 1-e11 / Idforntatiht� Worksheet JOB 1r STREET ADDRESS : E `u `i t 3yY} 1 C N t_ rjL��_.._ CIT\Ye/STATE/ZIP: rc;K#4"9- 9y Zi 2, PARCEL NUMBER: OWNER: Caq -M L 14 f;-Cz' C, PHONE NUMBER: MAILING ADDRESS: &7c't, -212- (street) 1Z(Street) (city/State) (Zip) CONTRACTOR: Q iv&c' LICENSE NUMBER: 0i f P�� C d PHONE NUMBER : S '3� 4 MAILING ADDRESS : IVB • 7 ( S N wx c4 V4 c ` (Street) (city/state) (Zip) MECHANICAL WORKSHEkT/4 EE SCHEDULE DESCRIPTION OFUUNITS XS = AMOUNT DUCTWORK SYSTEM_ _ _ _ _ _ _ _ _ _ _ _ _ WOODSTOVE/INSERT _ _ _ _ _ _ _ _ _ _ _ _ GAS WATER HEATER _ _ _ _ _ _ _ _ _ _ _ HEATING EQUIPMENT <100+000 BTU _ _ _ _ _ HEATING EQUIPMENT +100,000 BTU _ _ _ _ _ GAS PIPING (1 - 4 OUTLETS)_ _ _ _ _ GAS PIPING (5 OR MORE. EACH!)_ _ _ _ _ _ REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) REFRIG 101-500H BTU_ _ _ _ _ _ _ _ _ _ _ REFRIG 501-1,000M BTU_ _ _ _ _ _ _ _ _ _ REFRIG 1,001-1,750M BTU_ _ _ _ _ _ _ _ _ REFRIG +1,750M BTU_ _ _ _ _ HEAT PUMP & AIR CONDITIONER_ 0-3 TONS _ _ HEAT PUMP & AIR CONDITIONER 3-15 TONS _ HEAT PUMP & AIR CONDITIONER 15-30 TONS _ BEAT PUMP & AIR CONDITIONER 30-50 TONS _ HEAT PUMP & AIR CONDITIONER +50 TONS _ VENTILATING FANS L _ _ _ _ _ EVAPOhATItt CcobdiS'+_ _ _ _ _ _ _ TYPE I HOOD (PER 12' OR 12' PTN. OF - TYPE II HOODx CLOTHES DRYER ~ _ _ _ _ - _ RANGE_ _ _ GAS LOGr_ _ _ _ _ _ _ _ _ _ _ _ _ ^_ _ _ MISCELLANEOUS (NOT COVERED ELSEWHERE)_ _ UNLISTED GAS APPLIANCE <400,000 BTU_ _ _ UNLISTED GAS APPLIANCE >400,000 BTU_ - _ USED APPLIANCE <400,000 BTU_ _ _ _ _ _ _ USED APPLIANCE >400,000 BTU_ _ _ _ _ _ _ AIR HANDLER <10,000 CFM _ _ _ _ _ _ _-_ AIR HANDLER >10,000 CFM _ _ _ _ _ _ _ x$10.00 = x 25.00 = x 10.00 = x 12.00 x 15.00 = x 4.00 - 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 = 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 = t i 4 r' SUBTOTAL $ PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT 0. NOTE: I P IT EE I0 $35.00 FEE DUE = $ SIGNATURE , g Spoka a County Department of Building and Safety West 1.303 Broadway Avenue Spokane, WA 99260 (509) 456-3675..