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1992, 09-01 Permit App: 92007073 Gas Log, Piping a- --ie-7 - - tAscc,t40� (�1 (� MECHANJCAL,PE�RMIT APPLICATION FORM �`ve,cS•�`� Information Worksheet ce(n ( _aj - JOB STREET ADDRESS: 3 - / �o� C) `� ALJ J CITY/STATE/ZIP: Sp D k I INA. '7' 01-0L0 PARCEL NUMBER: OWNER: Lk i C•c r-6{ H lou`-I-an PHONE NUMBER:c'-Z'-/ - 91lq MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: F I C-e') G4t2bEiJ CEiJ1•E12 LICENSE NUMBER: F-41C,0 &C.,I-73 D LA PHONE NUMBER: (509) 9'r.?(o--891 / MAILING ADDRESS: 6 • q3) D -.5.px20914e- S•okAAte- wG} y92 p(o (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH . DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = ::::.:,.:::.. -------- x 25.00 WOO[3STOVE/INSER� ::>::.:::::;?-}h.,� if..i>::::>::>:«:::>:: = GAS WATER HEATER x 10.00 = G5 m. 0 siNo0uiNw .�.,0< w1 ,>::v } x 12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = ,/� --------f------ 1 x 1.00 = f:_p�u !°!„ ,:.....: .n...r.h,.,,��..4Ar,Y � .<-���s�,r?> 'i =,� BOILER/REFRIG 1-100M BTU - -f.: - xis -------- x 12.00 =r . : x �_ _ hn� my � � Vw �M„ . af - x 20.00 `- - V-.- BOILER/REFRIG_ 501-1,000M BTU; -:::-':1---:-",:----;---'- '"':--.. �: . - x 25.00'_ ' ::;,,,-,7-:".,- - rt, :� , [fflieW.1.3 i -,, „t,,,.,r x 3500 - ,. 1 Swaa��7�w}ra.a...w..��.. .k..,i-Yo1�ra r W ?cvrac.£,t � .. - - ;�nr rY.x�.�> J ,r y,,•_. BOILER/REFRIG+1,750M BTU-, • ':'-'.4Z- -''''.'..-: , {.- x 60.00 = • - _A �p�UMP AIR Tt'�ND C'il�1f=#lWa:A i '� 12-00-='-''- ` .. .... • x `., . _-•� ,. .� • HEAT PUMP&AIR CONDITIONER 3-.-15 TONS x 20.00 :HEAT.PUMI� .AiR:=OONDIfONE 315TOIS�f 225.00._ .. . ..-�: rmc . :: : HEAT PUMP&AIR CONDITIONER 30-50 TONS = N 3440 :$57 `} . - x 60.00 Y • r vYw.wu.{vC• m.W-AC4.waeMvrF.GiW ::i:K4Lrn :4:vxm diWv-}.v3C _v - , - VENTILATING FANS _. -_ x 10.00 = . : YA('QRATIS£C40LER , 4 <r£< :}}- ::>::>`=< x 10.00 = . a.....www.wr..a.,:._:w.:r.,am+:...✓t.-���..w.wr.:...:...51..,,wx,.;:r:-.usCv:;3i.C<cti`. ,.w..,.,-:a?t.,i..�.uw-:..w.:.:r<••r.?:': - .. - TYPE I HOOD_(PER 12' OR 12' PTN. OF HOOD) -- - x 50.00 -- �/v��r(yilyyJ}.yy'r. r:}i:{X-:?'r_v:+ir.:n+Ciewrii±Y_}}J-::;i rri:_+" v}:4{v:C^J:•i-?'i.:v'nivt.}:4ir.-v} ;TYPE II1H D :wvr vw:vm my CLOTHES DRYER - x 10.00 = .-ry.�,.-k.,.::??.::--r-•- :max--,�-:?<t�.;::};�}-->;-h }��;:. ................ f.,........ x 10.00 = .:}i}}}};??y}}}}}:i.Y:i?4:4}:4.:::iii::}`:>}j:+'�4:i::i iirrii:i.4'`.ii:`i:`viYi:is}: L<i.:C:i:�Gvi�i-: :::.v:.iGi::-: GAS LOG / x 10.00 = /0 00 :1111:. I:. CPtn NEOUS(NOT COVERED ELSEWOOkil i x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = .....:.......... UL NSTED GASAPPLIANCE •400,000 BTU <_: ;<'>::' x100.00= USED APPLIANCE<400,000 BTU x 50.00 = E . APPLIANCE>400,t?00 BTU }:}}-:::.;: _::}:::.::.: x 12.00 = AIR HANDLER<10,000 CFM HAND R iwt.R._ _ 0 000.CFM>><>:><><;:«:>:::::>:<:::<�:<::::><:<:>:::>::::>::>::::�;><;:<:<:>:::_:::::::»> _ . :::.::: .. _ �;::c ;>: :.;: : :_ .....: :: ...;: x 15.00 - ' SUBTOTAL $ xUD $- -PLUS: PROCESSING FEE +$ 25. 00 NOTE MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE = $ 3(0 Db SIGNATURE Spokane County Div , P:. ,dings