Loading...
1991, 11-20 Permit App: 91008051 Woodstove(Q J `- a - O (43 MECHANICAL PERMIT APPLICATION FORM C l , U 03( cm 0 (Z1U 0 I, 8 S( Information Worksheet ir JOB STREET ADDRESS: \ U15 M ? 1 eJr C . ec k Ao • CITY/STATE/ZIP: <� winPARCEL NUMBER: OWNER: 01 lei -An ' I\cn PHONE NUMBER: DCS - LICIS I MAILING ADDRESS: saaT _ (Street) (City/State) (Zip) CONTRACTOR: EA- ) C)d JI -FR LICENSE NUMBER: r4JC0 &c..1 -73 ,D LA MAILING ADDRESS: E . g 3 I D 3u E, (Street) DESCRIPTION PHONE NUMBER: (5040 Rc26, - ?C/ I / S KA�Ie, MECHANICAL WOR ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) GAS WATER HEATER GAS EQUIPMENT +100,000 BTU DUCTWORK) GA #'<IPING ii*A OU° BOILER/REFRIG 1-100M BTU } EFx :: ; it4 .tea t �‘;--a-A327 BOILER/REFRIG 501-1,000M BTU rte= kN "v"^r'^^^.�.: �f•+r:.: .}� - %•.:irx.•xxv. •i.:h r?_C<ti -. - _ i.:•inn.�AreMQWaaHhwSW W# aiY. i N } :Svlx }. .::� BOILER/REFRIG +1,750M kA11 C11=1: -T: .,...wo .•:.,c:-::iaa:}r.::-.:::.,.::..,..a......aia�.....�,:--N.�wcr.Www.acnca.»w.•«....i;•'a,}3s�: HEAT PUMP & AIR CONDITIONER 3-:15 TONS !!.}+:^wM>n-n..:.n}�:�'•�M�M�+--:.w..+!�:.wn,..:..,. { n. naPl, •• y:...,rwi:-.:}.:w.Y:n EAT:: ?t )MP c AIR C05N1 I /W 7 :.a:..-.t�.hw:.,.:: v>],,,,.:.,�.:•.,�. , .,,,�a -•- ,wa�M.:wwy.•.,. ,r«�.N,••.•crs.::�'v'}. HEAT PUMP &FAIR CONDITIONER 30-50 TONS? 2RIQ++v�•� nM�e�oc. xeu::.,eca,�vrca: c -:i.---: VENTILATING FANS _' _ 101011ll+-i�`-'-:,-::yAti-i•'�`.-`:3.ff .� •ii::[.}:•i\R }.: TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) GAS LOG MISGI*i LANEOUS (NOT COVERED ELSEWHERE: UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED GAS APPUA(CE>400 USED APPLIANCE <400,000 BTU 'USED..APPLIANCE >40:O,Oo0>B11.1. AIR HANDLER CFM . .......... AIRHANDLER>Y0i000 CFM ;> NOV 1 1J::11 NOTE: MINIMUM PERMIT FL -1S$3510Q4 Y )..m# 992Deo (City/State) (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x 10.00 = x12.00 x 15.00 x 1.00 = x 12.00 x 20.00 x 25.00 x 35.00a x 60.00 - x12.00 t x 20.00 x 25.00 x 35.00 _;' x60.00 x 10.00 = - x10.00 -.. x50.00= x 10.00 = x10.00 = x 10.00 = x 10.00 = x 10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = 1 213 -c4---) ,-_ ;. ., s ;;,4, ,;t,;-; - ° . <.:. . , ._, -"'`,--.:14., °t>r_. -. ° A,Av ;$ ,-.1- „. ,t . > -` .. . SUBTOTAL $ 3G-> CO PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ 5L ED SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane. WA 99260 (5091456-�S75