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1993, 04-28 Permit App: 93003018 Mechanical Fixtures • •_ -3- ` I � MECHANICAL PERMIT APPLICATION FORM Information Worksheet �� JOB STREET ADDRESS: >• a1O 7 ! , i I/'-:, . cAlw" __c� \AS tx.S CITY/STATE/ZIP: t,I*i . �Gf2-D _ PARCEL NUMBER: `4'Sa-.`;1q 6LL0c7 OWNER: /,64 Vl.f 4' xtvwue...iirt,Jeiv PHONE NUMBER: 7L/-7 MAILING ADDRESS: (Street) (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 = - .•-h:;,;}a `':.'S•.'':=:::$.'.•:{rf'>•'1£-xk::<:: 2 = €1N��1� 'C' ��f(t�SB•mt. �• i'4$•,•::;-,•.:$•;r>}•::}}:.:;>::$: :Y::•.�,u..;.:>.: x 5 00 GAS WATER HEATER t x 10.00 = /(}, 00 :{ {N.••:xrv,{:nv:;x .. •r, {xr�: :{Yxv:nvx:x.}..lvnrxxy:.•x•J r . e •>•_ ::1 i $.e.a w.;; 1: h x �: ;{ x 12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) w x 15.00 = genta.wtiv{;.v.•ti.. 4 ><.r Ef'w:«.-�,�:�;{ :• (7 x 1.00 = BOILER/REFRIG 1-100M BTU x 12.00 = Vait{{vv:•.,•.:}:•::••,•.v,::•.,•.:•vyx�ryy. �,r J };l•iiY.'i{:f}}vv:Y�}k;i vwc�.; :},�f- tf 3BF .�y( 8:s:ate:: } # }� p M, x 20.00 = :}r{:ii v {v',t\y. .,v. Jhvk :$}:pn{$::'h•:+iv'%v,•vi:: .Cti-:nx••: BOILER/REFRIG 501-1,000M BTU x 25.00 = shy{ ,.<:•.:<;r.- <.> x 35.00 •h• •r/l.'v$iv{,vi:•Arh. 'vAw\,vrAM'N.4irA}, .'•.{:h\4ti•:i:•:2•:{v .hv', BOILER/REFRIG +1,750M BTU x 60.00 = : x 12.00 = HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 = v} .mow. }]aW.Y•,vl:M'µ'-.^.•y ' is 0#:;.vr : o o _ x 25.00 = HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 = .� :r.,.:rrr{,rcr t.,,air '• .. ' 'C at ' :•£` x 60.00 = VENTILATING FANS x 10.00 = Q.n .Y:MYxv+v{{r{ fr 1:.: 14•::;$�.v .�}., f raatit.•a a. a s x 10.00 = TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = wr- a'{nc rr:r:.,v.,. r sy2�!:22.Yom" •rr !: Mri .[x': ;}d .£ Y: x 10.00 F:•.F•, v:. iy.•.w�:..,i-{r•-g'M::r:��'°."v s, �'" Gic:ra�''-•��s ;: a�`{4'•{:a'�rV.:}:i.•.u}:;:$:?';;. _ CLOTHES DRYER a a.S / x 10.00 = it) 0 J r{.,v:y.,y,...}..� .c::i?:••: {$#.,r ;,o •.'+ )� {,;::;}:$;:<{:rT'f�r�',•`ac.,.r ,,;�4,- •_a� (� ,. f > .' :},•�=::x :;.��>:,'• ' I x 10.00 = :v"•ry'r��:�v''r:••56: .. .�� !ai`•fi `#:'{r:�ne�cu'�':`o{ .:-:•:tt GAS LOG x 10.00 = OISk$' f ::£; .•:.`;xr;t n:`• . x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = •M:nv::.•:.Y.x.r:•:r4vwr.} +C••MYxN• } Wr{}v. �v...Y.:}•.v:ti;.vr{ I II 4 tagi f k a 11 t? r : t:::<_ x100.00= USED APPLIANCE<400,000 BTU x 50.00 = y+}vx{:nvr.,;H�.,•I:.•.;x F{{r:.vy:.},y.••v:{xt��xr:.Yr,�rr^^W�rxr N+S.}rM'J:wr�iF:f Sj?,•::-$::,�,4:S�y?�i�;{?v}+r'y{%ri:'ii' #t1:Sys:1►f> 'f*:f:A IG i •t,3f�!A::t 'C' . r ry:$<n: <.r:IN > ; x100.00= fi: nv.•xrv:}hvxvm.:v:x::nv.•rvV.vS.vmv$xrwWrm:xrw4x�n:.v. .....�..r.......::r......xn....x...h. rr.... AIR HANDLER<10,000 CFM x 12.00 = *Y{•v:::{{..:$.�.,.::.;,::.,;..•$::,..,::•.�.s}:;�,`�'#�,ww•x.:,�.,,a9•.r i..%'�e;i}:•r,,?K .?:.}•.:;:: •}• `•::`:'•:'•`�'d< :: �-•��{�.y(, ��y{ A`r�,fi...}�,r 43.y.>:.;.;,.:ir::�;> .h•.}r;:..$'�.. }{... x 15.00 = }.•:4$� �:��i.:Fyv:.��:M:X•�•!'� v..4, •a:$:$}$$$$}�iii$.`i.`:v:(.'}:f•J{}2.•.i$5`vFn$?$i: v.•nn..v....v..r..v:r.............r..v.....nxx..vw.Ax.,,W.$vv.�:.'��•rrn�.'i•:r•:;•:.v:.v::r•x::.v}hrn..: n SUBTOTAL $ c, DO PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE =$ Al`T, O d 714 ' - SIGNATURE -E Spokane County Division of Buildings