1991, 09-26 Permit App: 91006275 Furnace, Piping SPOKANE COUNTY DEPARTMENT OF BUILDINGS
W. 1303 BROADWAY AVENUE
SPOKANE,WASHINGTON 99260
(509)456-3675
I certify that I have examined this permit/application,state that the information contained in it and submitted by me or my agent to compile said permit/application is true
and correct, and authorize Spokane County to proceed with processing. In addition, I have read and understand the INSPECTION REQUIREMENTS/NOTICE
provisions included herein and agree to comply with same.All provisions of laws and ordinances governing this type of work will be complied with whether specified
herein or not.I understand that the issuance of this permit/application and any subsequent inspection approvals or Certificates of Occupancy shall not be construed to
give authority to violate or cancel the provisions of any state or local law regulating construction,or as a warranty of conformance with the provisions of any state or local
laws regulating construction.
SIGNATURE OFAPPLICATION
r
OWNER OR AGENT ,C,c-c€421/Z, /���d � DATE � 7
PROJECT NMB: = 91006275 rLt1 : " ItN DATE= 09/26/91 PAGE= : 1
•. x*3:•x3• THIS:• .., NOT A PERMIT * •.*•n•*
!"E ' F•?!... ! .3:E w+.Li... BE ASEESSED FOR COMMENCING WORK WITHOUT A PERMIT
:SITE STREET= 1225 :.: :')•it,tt. t'..,:r,: RD i•'A:4 L.i:.i_.v= 23544-1107
ADDRESS= tw ER`.r•"•?DAi...i::: WA 99037
PERMIT USE=C:.= tx f-?: t"?.;!'t t N C!::. & PIPING
PLATO= 002751 PLAT NAME= VERA
BLOCK= LOT= ZONE= SFR DIST4=
AREA= eI0000000 F/{.`.?:::: i- WIDTH= DEPTH=H:::: R isi::::
DIET
-,:• OFOFts....?.1t:r •:::: ! �,;: DWELLINGS=DWELLINGS= �r)f•i :.•t:
isbJt'o.. .;:::: E.; i t •.t1v ERVEN t PHONE= 509 922 0646
STREET=3 :::: -i x..25 :s PROGRESS RD
fai:??:'ri.,'E ::::: uE"l ADAi._F WA 9903
CONTACT NAME= ERVEN ER"IC::i<,SC:tN PHONE NUMBER= 509 922 0646
BUILDING SETBACKS : FRONT= NA LEFT= Nr`? RIGHT= NA REAR:: NA
.k :•1h***:H**•!{*P*P:.l**:7{*****A. .*P: :•A:•.i* MECHANICAL PERMIT **R &P. ! PHPPPPPAPR lANPA
tC
CONTRACTOR= OWNER PHONE=
OWNER
..TEM DESCRIPTION QUANTITY FEE AMOUNT
PROCESSING FEE 'f '')E:z 00
GAS i"i•1 t..v l::.l•,:'1..t.l.l.::' •! 0 t:)= '. U',2;r:TI i ) 12„00
GAS PIPING 1 . ..00
PERMIT TYPE FE:i:" AMOUNT AMOUNT f'f':?I:o AMOUNT OWING11'
"!ECHANICAL.. PRMT 38,00 .00 :3 :i,00
E3 0 00 38,00
PROCESSED BY : :.iUL..IE: SHAT! _..?
PRINTED BY : j.j.....IE SHA c:t t
3,.:A:Jt....... *.f.•...P:.......1t..�R.. :)t 1...�:'....t,.:)[.�............��.... THANK '7'C)u .P:. 3*3.94 3.9!•J!•N:........P It.....-...),:3i..p...*.1,..1,..t,.*.P:*3 3:n:
MECHANICAL PERMIT APPLICATION FORM
-,information Worksheet
w
JOB STREET ADDRESS:
CITY/STATE/ZIP: PARCEL NUMBER:
OWNER: J' ) & o, Sd-A. PHONE NUMBR: 7a? - fG
MAILING ADDRESS: ✓` / RS-A--.„7 Vey all /41k 77c-5
(Streepq`) (City/State) (Zip)
CONTRACTOR: LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT =AMOUNT
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 =
NEEST-unv::::}•:x•• IMBEIEvw122114
x 25.00 =
GAS WATER HEATER _ • x 10.00 =
-ems = a::.:..:0 t ::M•..:. .I'a177C - �` x 1200 =
GAS EQUIPMENT+100,000 BTU`DUCTWORK) x 15.00
I : - - =
-• .--:� x 1.�/�/
BOILER/REFRIG 1-100M BTU x
12.00
TMt yxY xuvI Y .-1 3WN) s1- .
BOILER/REFRIG 501-1,000M BTU - x25.00-=
ffFikAE�I'x.�`I:�,„#t�41: _ . . x35
BOILER/REFRIG+1,750M BTU ,
TO. R �}' E`D ONEI :sof }Q7 rx 1 ZOO u"
} +1eP 1ArHs4v- A' 'A"" `: Y.uxh fi ova i
HEAT PUMP&AIR CONDITIONER'3=45 TONS x z 2000 ':vx
EA: M ' 11'tiF
M !A @ ® � ;Px^ vlr:.. @
0. 2r iee,a'T fid} s <x x /�f Yar ✓
VENTIU4TING FANS"� i r! a� sFy i w r. fiy S 0 °4i� 1*m +4`; i.`.
TYPE I:HOOD(PER-11 2'ORx12'..P TN:;OF H000104,7-;%'
:_:}_ni-..r�snh yi.tY}:.C'-•'i`---- `'v r}?: >: t •
x 10.00 v�C. Z2, 'M.:.,3s ZH5+�-�+i.4 gh.
M 'k .�
CLOTHES DRYER -x 1000
�":'�"-:"%- ^'-.:tdci�'+FA%S%✓3<':;¢oc .q::_s• �ncee�c-. � 3� � X
:, 1���i �'` f}.:::::-..:?.. `-;''v �"`�Q+..::i• ii :::•::::::.:}:?:gin +�i`�at' ..
{ -': ..d}:�?4. ::!;:L3..• .aL4'S-y: .vt:., nh
- .:iAsv :�?: -c vi4'Tn� �v.•nCV:ii-:Tn�u-i:--2ixxOYinti'J Li-1if+.v tiv�.}b.
GAS LOG _
x 10.00
MISQ IiANEOUSkNO VERED EWEWHRE >r<?i< I x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00
UUNSTED GAS APPIJANCE5400,fl00 STU:__r: x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
X1 00.00_
AIR HANDLER<10,000 CFM x 12.00 =
AIR HANDLER>`10000 CFM .-, x 15.00 =
SUBTOTAL $
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS:TOTAL PERMIT
FEE DUE =$
SIGNATURE
Spokane County Division of Buildings
West 13n' Rrnariwav Avon! Cnnkano WA 000nn /�1101 A CA_' 7