1991, 10-14 Permit App: 91006798 Water HeaterWCHANICAL p8AIl M-- APPLICATION FORM •�_ �- �--
Ihfc�is4i Worksheet
JOB STREET ADDRESS . l 3 O G3 fp-
LA 0
CITY/STATE/ZIP: g I PANCEL NUMBER:__
OWNER: _. rj r" uol w PHONE NUMBER:_ 9 2 7 P3 7 y
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR:.___ F til It1t-110ENSE NUMBER: $ANNEFF378NT
CONTACT: BUSS LtM9 PHONE NUMBER: 535-1711
MAILING ADDRESS: P.O. Sok 4346 Spokane, WA. 9§202
(Street) (City/State) (Zip)
MECHANICAL WORkSHEET/FEE SCHEDULE
DESCRIPTION
CLOTHES DAYEA
(SEP ATE SYSTEMS)
RANGE 't-
�ELECTRIC/DUCTWORK
\•���S�V����V�1�....._vv. ��.:{�r'::,..::.:.v:.n:..<�:i
p spy
F+XyJ; ,{
S',.. 3`YY
r,AQS} WAVE
HC.EAi-'Ef�j%-�..:,-
MISLC.�i1�1i=`(N iLSLCi1g1✓
jh
v7AV?ii�C.,l,',iV��kVV,ry\IIL�LJE�.''i'}.';.:".�`:
GAS EQUIPMENT +100,000 STU I3UCTWORIq
,
GAS` IPING (EA OUTLET) "'
meq:
BOILERlREFRIG 1-i00M STU
'L�
B6ILCi1(f1Cs1L11:J
< <
BOILER%REFRIG 501-1,OOOM BTU
SOILl=1l�REis�#I 1',060'I t7#�il S'Y'tJ
<
BOILER/REFRIG +1,760M STU
r
HEA' PUIv)PA:Alli CONpITICNEI 0-� TONS
HEAT PUMP & AIR CONDITI6NEI'l�$-15 TONS
t'
HEAD30 TONS'``
HEAT PUMP & AIA CONDITIONtA 50.50 TONS
HEA1�CiIPI# CCN)ti�Ib:f6N5.. ..:...Y
A '
G PANS
TYPE I HOOD (PEA 12'_OR 19 . PTN. OP H
NUMBER
` UNITS
CLOTHES DAYEA
-AMOUNT
RANGE 't-
x 10.00
x 25.00 -
x10.00 gev_oo
x12.00 it
x 15.00 -
x 1.00 =
x 12.00
x 20.00 -
x 25.00 L-
x
x 35.00
X 60.00
x12.00 =
x 20.00
x 25.00
x 35.00
x 60.00 -
x 10.60
x 10.00
x 50.00
x 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
GAS LOG
., .,
MISLC.�i1�1i=`(N iLSLCi1g1✓
ZX;
UNLISTED GAS APPLIANt;Ir � .'0'* 00 STU
,
ULINSTt At; A RLtl�I�t����,�dly BTU:..
meq:
USED APPLIANCE <400,000 ATU
'L�
USEt�''AI�PLIA�IC+d(�t{'f
< <
.
AIR HANDLER <10,000 CPM .
AIR HAIViIrI=IO;OOO tyM ">
<
r
NOTE: MINIMUM PERMIT PEE $55.00
NUMBER
` UNITS
X EACH
UNIT
-AMOUNT
x 10.00
x 25.00 -
x10.00 gev_oo
x12.00 it
x 15.00 -
x 1.00 =
x 12.00
x 20.00 -
x 25.00 L-
x
x 35.00
X 60.00
x12.00 =
x 20.00
x 25.00
x 35.00
x 60.00 -
x 10.60
x 10.00
x 50.00
x 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
., .,
'L�
2. e c
A '
,>
SUBTOTAL
$�:00
MUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
A< FEE DUE
y $
SIGNATURE.
Spokane Utlmffbmsion of Buildings
west 'l8d3 Broadway Avenue 806kahej WA 99260 (509) 456-3675