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1992, 09-01 Permit App: 92007102 Mechanical Fixtures ti U \ \ \ \-- MtUtHANIGAL P RMUU APPLIGATIUN FORM 9,1- I I04 ( L-\\ \0-"D ,270`- Ir..formation Worksheet i 1 CP0 JOB STREET ADDRESS: DA,,,,,,- `�5 O�3 -- , . CITY/STATE/ZIP: 44 / Zlh g�',ge PARCEL NUMBER: OWNER:,(Q©Y(,CZ(d i l) PHONENUMBER: 9 / 9�1 ,' MAILING ADDRESS: /q7 ' t , O,/,p���� . „ed g'-tom,,, (/2 9g, -.e (Street) (City/State) (Zip) CONTRACTOR: 141,614a /GL 2 12QMIC LICENSE NUMBER: -_5E-4 k '/2_- 319--AJ PHONE NUMBER: - 5z,8-s- . MAILING ADDRESS: Po 6- 3-76-� rylJLa_e4 , /fiat cigc oo (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT = AMOUNT DUCTWORK SYSTEM x$10. 00 = WOODSTOVE/INSERT x 25. 00 = GAS WATER HEATER / x 10. 00 = /0 , 690 HEATING EQUIPMENT <100, 000 BTU x 12. 00 = / ) ,p/1 HEATING EQUIPMENT +100, 000 BTU ! -4-re e-= 1).� = / GAS PIPING (1 - ...4_ OUTLETS) x -4e-= 0 0 GAS PIRING (5 OR MORE. EACH: ) x 1. 00 = REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12. 00 = REFRIG 101-500M BTU x 20. 00 = REFRIG 501-1, 000M BTU x 25. 00 = REFRIG 1, 001-1,750M BTU x 35. 00 = REFRIG +1,750M BTU x 60. 00 = HEAT PUMP & AIR CONDITIONER 0-3 TONS _ _ 4 x 12 . 00 = /, ? '(Q HEAT PUMP & AIR CONDITIONER 3-15 TONS _ x 20. 00 = HEAT PUMP & AIR CONDITIONER 15-30 TONS _ x 25. 00 = HEAT PUMP & AIR CONDITIONER 30-50 TONS _ x 35. 00 = HEAT PUMP & AIR CONDITIONER +50 TONS _ _ x 60. 00 = VENTILATING FANS x 10. 00 = EVAPORATIVE COOLERS x 10. 00 = TYPE I HOOD (PER 12 ' OR 12 ' PTN. OF HOOD) x 30. 00 = TYPE II HOOD x 10. 00 = CLOTHES DRYER x 10. 00 = RANGE x 10.00 = GAS LOG x 10. 00 = MISCELLANEOUS (NOT COVERED ELSEWHERE) x 10. 00 = UNLISTED GAS APPLIANCE <400, 000 BTU_ _ _ x 50. 00 = UNLISTED GAS APPLIANCE >400, 000 BTU_ _ _ x100. 00 = USED APPLIANCE <400, 000 BTU x 50. 00 = USED APPLIANCE >400, 000 BTU x100. 00 = AIR HANDLER <10, 000 CFM x 12 . 00 = AIR HANDLER >10, 000 CFM x 15 . 00 = SUBTOTAL $ 3,5- PLUS: PROCESSING FEE + $ 25 . 00 EQUALS: TOTAL PERMIT NOTE: IN MUM - FEE IS $3100 FEE DUE = $ (PQ SIGNATURE4 , 0, i'6; Spokane Cou 44De artment of Buildingand Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 ,U Li yrs RESIDENTIAL HEATING SPECKS• , JO8 FACTORS 1. LENGTr? OF LINE SE i 2-S - 2. LNC-:r1CFELECTRICAL Z. TEPMCS T AT A. GOOD /LjeZ,6/ E. AVG. C. BAD 4. ELECTRICAL PANEL. A. TYPE ML4Kgpi E. AMP. �� � C. MINI STANDARD 4- 5. CONDENSATE EE PUMP YES � NO 6. BLOWER MOTOR YE-4 DIRECT NC BELT 7. I-:E.AT7NG SYSTEM T VPC / CZV .1► Nif PAY TO A 11 V VVI 4C ISCLHr ANL) UWDUI'tacivICIV 1 VVU .n rt STORE NO. STORE '�d1�Gt IL No. 780405 DATE (f--- /- 9 -" CUSTOMER'S NAME SALESCHECK NUMBER JOB I.D. NO. OR WORK ORDER NO. AMOUNT DUE CONTRACTOR ALLOCATION OF EXPENSE - FOR INSTALLATION OFFICE USE ACCOUNT NUMBER DIV. NO. ADJUSTMENT ACCT. ACCT. CONTRACTOR EXPENSE MEMO SELLING /01tViza_oi ., g, aa375-g 6002 43el. 6,,. , o/ /V/8L.Ob ,'i U,`el.A.) S PI.» I certify That the installations listed above have all been completed satisfactorily in accordance with the speci fications furnished me. TOTAL AMOUNT OK TO PAY TOTALS (AUTHORIZED SIGNATURE) CHECK NO. (CONTRACTOR'S SIGNATURE) 14489 (See Bul. 0-187 Part 11 Supp. 8) REV. 3/91 SEARS FORMS MANAGEMENT (DATE) ACCOUNTING COPY PAYING UNIT NO. lD 77 PAYING UNIT NAME (If Different)