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1992, 12-08 Permit App: 92010744 Mechanical Fixtures
f30\\ ,b k\ -J t.' l`-`5 r � " ��, , l3( A MECHANICAL PERMIT APPLICATION FORM 1 Z' e\\ • Information Worksheet . \. (0'. \� a_f`c1 175(-1r0_ JOB STREET ADDRESS: � �\ CITY/STATE/ZIP"�'�-•1 (> �� PARCEL NUMBER: OWNER; .3\`C`c\VO-C"-PHONE NUMBER: C-- - -14--V (12 MAILING ADDRESS: �--_ (City/State) LICENSE NUMBER: PHONE NUMBED MAILING ADDRESS \S(1:\ (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE "DESCRIPTION ELECTRIC/QVCTWORK (SEPARATE SYSTEMS) YY• �i'•ttil�t ( per+ '..{::r •• ;;:>'� {t,,'{?:. ,•{:: •}:•s �:'y's't3j?:}.ti:G;y%'r. �':�'t��;�r''�:'?<f'?4 .t4nF4T,• �IN.L%}}:}}:yJill.�:is�''��'�•�'{.d:AWr.'•Y.vfv.<i•: }}}.i•: Y:i:�::iii•: GAS WATER HEATER :C:tQQ000`T.v.;,..1{ s1%t7:.i*S<'_><>`: GAS EQUIPMENT +100,000 BTU DUCTWORK) BOILER/REFRIG 1-100M BTU (Zip) NUMBER OF UNITS X EACH UNIT rx>y�• BOILER/REFRIG 501-1,000M BTU -%...;i.. ill.r 1, {].S_:•,.YMY:Y�JiY(C:��.y�e,i:•:{::•iy �<tii:i}j:.:nl}:'r,.;.?••.,{,y, ..:... �vW:wii:•h•.{4}: :vi::::i}}yii:YY :v+;L:>{:'� BOILER/REFRIG +1,750M BTU JAIIMEI.:E:0+3T HEAT PUMP &•AIR CONDITIONER 3-15•TONS • Y. ''Yh•.y+¢. Y:.�u•,}Y w{,.rH� v;v.:4 •.}:Y: {�w::: n•..::.v •.Ynv. y., 7o{TTONS HEAT PUMP &AIR CONDITIONER 30-50 TONS T q VENTILATING: FANS TYPE (HOOD (PER 12' OR 12' PTN.OF HOOD) Q�'„':y .'Y,,•pe:}••':t•,.n:•,•,%;Y1•yyo,i%.y0,...".;Y;:•••a••,::?r.:.......:......... .(3. jay%.4.,,,g::_::r• :%•.•.:,..:4?;.•:.:„•.;.}'}$uti:•� f::::::::„., •::;::f: CLOTHES DRYER GAS .LOG k MvuG�EQ?SEWF UNLISTED, GAS APPLIANCE 400;000 BTU • U ISS t<CEQO;��OWBTtJ .T USEQ`•AI?PL IAf CE.<400,000 BTU .NU AIR HANDLER 010,000 CFM MINIMUaPERMIT FEE IS $35.00 5 SUBTOTAL x 10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x 1.00 = x 12.00 = x20.00 = x 25.00 = x 35.00 = x60.00 = 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 = x 10.00 x 10.00 x 10.00 = x50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = = AMOUNT $ PLUS: PROCESSING FEE EQUALS: TOTAL PERMIT FEE DUE pokane County Division of Buildings West 1303 Broadway Avenues Annknnn 1AIA nn'cn + $ 25.00 a��