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1991, 05-22 Permit App: 91002803 Gas Piping . MECHANICAL PER!►5IT APPLICATION FORM riiformat ort Worksheet JOB STREET ADDRESS: 6 / I r ger CITY/STATE/ZIP:cCy9Q', 1 UJl4. ' PARQEL NUMBER: OWNER: f.. /9/vie 1f LI L) PHONE NUMBER: MAILING ADDRESS: (.5)417)1, .._ (Street) (City/State) (Zip) CONTRACTOR: .�7 j� 5.ya / L-f=�' LICENSE NUMBER: 1/6005'-777---/0-4,2./ PHONE NUMBER: (.3<„4------j'2� MAILING ADDRESS: /14 /()(9k L'l? 7 c.S1� '4 TJ✓ � r- ---.2-.0)V-•--....._ . (Street) ( • (City/State)I (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE - NUMBER • X EACH . • - DESCRIPTION • OF UNITS . UNIT. =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = • ......4C '[ ISE ` r:<`>> <=:>`< -> <<:< > >>KSION:» :>:<>Y x 25.00 GAS WATER HEATER _ x 10.00 = - n.::f•;s :.{v::}:i:.n:;.:nv:F`J:.tii.:f-•.iv.:ri.r:tixni vv; ::i•::ni•:f..:niv::.yvi:.:i�:r,..r.•:}..• Yy:..::::.: --.'GAS 1PM-0 0OO BIL : CLU ES v R 'Y`` =': x 12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = GAS'PIQING(EA OUTLgT 4.. - > :.:.:.>r - x 1.00 = BOILER/REFRIG 1-100M BTU x 12.00• = - • .:. yw+ iinyitv : :M' T•:(xhiiviin}:neifyi-o ,B01 ' s • } : iv: X 20.00.= BOILER/REFRIG 501-1,000M BTU • "• x'25.00 t::n:::-,.::,;. ::x:N:;;,.. .,:;.`,.;i:..::n::::,..<n;:;Y..:: -;;::i:.i:::;,:,:<;:r-;s:;<.<;;:;;r;`'::,x;;r� BOII RIG 0 '`s0M .:.::r:;:.��:: ...._ � TU .:._::-:-. z 35.00 = BOILER/REFRIG +1,750M BTU x "• ..... 60.00 = HEAT MP iARVONDITONER0 3 TON < x 12.00 = HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = • :HEAT PUMP 1 AIR cONDiTIONER 1.5'. ?0 TONS x 25:00 = HEAT PUMP 4 AIR CONDITIONER 30-50 TONS x 35.00 = .HEAT PUMP$AIR CONDITIONER-+50 TON$< ;€> >> :":":;:: • x 60.00 = VENTILATING FANS x 10.00 = - :;igwoRgimegOMMESiiiinaggiliiiiigiNEMOSE x 10.00 .- TYPE I HOOD(PER 12' OR 12' PTN. OF HOOD) x 50.00 = TYPEI:L.. = .........: :.-o::�:<_::.::.:�:::::.:�:><::>:::::>::>::>:::::::>:»::>:::::::<::::::::::::::.::.::.::.i:;.i:.::.;;:::::.:::.::.::.:::.::.:::::::::. x 10.00 - CLOTHES DRYER x 10.00 = :RAN.;:.:. . = ::::: :iii:.:.::.:::<.;:-:_:.;:•;�.:;;:.;:.;:.;:.i".;�.i:.::.:-.;i:<.;:.;:.;;:;::::.><:_::;;:::;:.:>::»;:<;:>:>:::>:::�::>::>;:::::>:::�::;::>::>:::::«::< x 10.00 .:..::::::: GAS LOG . _ _ _ x10.00 = q•:nrr(■vvtv::•y�+Y.� wyw:n:•xrr{:.yv Fx tr{.vnv. Y`.i.I,�■ �`yl�y�y�y.�� 4 rA Sf .r O•.Y•" ``. 'E1 EI -rE.?? :•.i:ltil.:i•.::;a,.,..t.`. NN = n..::�:n.<nv.�...:�:,n:.,:•:::::�n•::::::. .•.�:.:•��'�'-'.��:-:�-".:.'�.:..�;::_::..::.�:.�;:•;;::.....�.. 1N.;:;-:_;:.;-;; ::i:•i::;i.:<.i-::::: - x 10:00 UNLISTED GAS APPUANCE<400,000 BTU • x 50.00 = ilAi '.. AASK10 >::: 1,t <:<i::i::> ::;i:.<:;.;:;::>;>:>_> x100.00= USED APPUANCE<400,000 BTU ' • x 50.00 = •:;� firir:n:•r eew H.tY:_:ryi:.i y::n:":n:¢';+:•:'ri•:':i{N1{•{• �{ixi r.iYr_+,t.J}.:ffj�:i}-� • - r:::.v.: AC1:, rM: 1:;=i;`}z� .<.s.,.}{�fin:,.£;� x100.00= •.w.•.o,.n:•:a r..:ov:•::.. x.;.�:•:i.•n...:$:-:n:•:::,.�':F?x ::-3:.:,;,,.r'�4cr''�k'�`�..•V'.••4ic3r:'•:�t:v":#�:::.i:;.:-. AIR HANDLER<10,000 CFM X 12.00 = ' )Algab. 14514WOEMB>{<`: : `r<:< :>< x 15.00 = OO f4: Ornt-- 04s- /-62k !J/ SUBTOTAL $ /d _,.-- /Ui5c rkari , PLUS: PROCESSING FEE • +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS:TOTAL PERMIT FEE DUE =$3(j, . • SIGNATURE ' '-5i:,,; ; - Spokane County Division of Buildings . West 1303 Broadway Avenue Spokane, WA 99260 (509)456-3675