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1993, 03-02 Permit App: 93001165 Woodstove (-15 ) MECHANICAL PERMIT APPLICATION FORM -rree\-4-uk-1- .'itr-i-J.3 06 - 2 Information Worksheet , ICIZIe JOB STREET ADDRESS: z/305- /\./, if e Ma ie_ CITY/STATE/ZIP: ,*°01)/(19--A)e_. t()la, 9 ,:: 0 6 PARCEL NUI.AELI:i: OWNER: KA-Aid y oy k PHONE NUMPI-.I . MAILING ADDRESS: ' B (Street) (City/Siace) (Zip) CONTRACTOR: Y,-Je ig.e-i-A -a- 9bI0 in €____. LICENSE NUMBER: kjc_4_&-i- 0.2.5-,)3 PHONE NUMLEP: MAILING ADDRESS: Ai. ,333 :/// /0A) --5e24/9/ii(?„7 /A)g. 2_9,??_/75' _ (Street) (-ityi1:.11.c,) (ZiP) MECHANICAL WORKSHEET/FEE :LA:. ,,_-I:.-.;ULE r .NUMBER ' X Ef-ki,_:•H ! - 1 DESCRIPTION OF UNITS UNIT 1 = AMOUNT I ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 - ' i..... ...................... ....... ....... .......,::::„... „. ...... . ... ,...,, . . WOODSTOVE/INSERT:::: :,::::::,.,,::::::.:::,:::.,,::,,,,,,,,,,.,::::..,: - ::,:••••• .,..::::•.- .'' \__ ,' x 25.00 = c-.3' _ oc_ , .: .....„,,......:...:..........„.....................:.......: :::: : : •....-....-:......„„.::.::::,•..:::::.:::•.• GAS WATER HEATER >; 10.00 - - i 04$!g..0:VIRMg.NI.Wq0.;.90.0.aEirti (IN00JoEsA,::iiiel':,::Mi 1 x 12.00 - GAS EQUIpMENT+100,000 BTU DUCTWORK) 1 x15.00 = p4igfpwp,'( A1.0.0T.rj');0:TiN::;:Qi::NA:%:::::,:: :::::',.,'4.''': ::., . , ...' 1 ,: 1.00 - BOILER/REFRIG 1-100M BTU , x 12.00 = _ f.'z..0.1e:W14teR1.0!]ii0;40(iNii:OTVIER:1:!!!! ::ii!,!iiinii:;E:%: :5ilig:: ! x 20.00 - BOILER/REFRIG 501-1,000M BTU x25.00 - ... ........ ... . . ............., .......... .... :.... . ................ : . . . B.10)14g90 ..EF.paiiCQ1061'41g50MBT:U..M:i.'qN1006: :::.:• :: j x 35.00 = BOILER/REFRIG +1,750M BTU x 60.00 = FfOiktiikOMI9ikAtk:CONOITIONE9iii43117(..)NSMR:i: :: ::: , 1 x 12.00 = HEAT PUMP &AIR CONDITIONER 3-15 iONS. I x 20.00 = -igAfflog...!..,;1pi :!Ai9.06,pjTipNFFi!15917.pN.5%•'•..',.:•:''..:' x 25.00 = HEAT PUMP &AIR CONDITIONER 30-50 TONS x35.00 = kik...fig:04k0..J.i0Opj.T..jpoFF,u.*5.9.:,:iT:.QN.qi!..:!im.,:.0!:, :i: ., 1 x 60.00 = VENTILATING FANS 1 x 10.00 = tVg0:6AAtiV..tbddLE :OM:i:onam4:::::N: ; :i:l... :;•:..-'':l•:...'H - ' x 10.00 - , ..........................................,.....................................,................,,,....... ...............................,..........,..........."..".. .... ...-....:... .:. TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = T*...e:01:111..:EiiiMII:ii:IV::: :,g;::: Mgia!::.S1:.'1: : ',:'M%••:.•.• ::::••i:.. 1 10.00 = CLOTHLS DRYER ' x10.00 RA................,:,,,,..,...„,..,,,,„........,...„,,„.... „... NGER:: ''ii.H','.'..- ::• ::ii ::.TEi :'.:H'.: -.••:•.:.:. .•,c...,,:.,i-.• ::::,..,.....•, . -. x 10.00 - GAS LOG x 10.00 - M10pE4ANEOOSANOT.covEREp.Et'..sEwHFRE ''.•• ' x 10.00 = ... UNLISTED GAS APPLIANCE <400,000 BTU I x 50.00 = U1..!NOTED.IGAsAp.pt44NcE;i400,opo Bi-u-:,. . 1 xioo.00 = USED APPLIANCE<400,000 BTU 1 x 50.00 = Uatb:!AppLIAJCE.:: ...400600:.',BT:11. :':g:' :- -:' :',:'.1.'1.'",'::'::1:.::.:.::',•'::H.: :1'1j j1 xi00.00 = AIR HANDLER <10,000 CFM 1 x 12.00 = AlkHADLER>10;0.00•,,CFMM::::::..:igiT.':. :, .... .1J1 ..J ' • j x 15.00 = ---- -1 • SUBTOTAL $ PLUS: PROCESSING FEE + $ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE - = $ •CO SIGNATUR \ Spokane County Division oildings West 1303 Broadway Avenue Spokane, WA :,(-,v-3.00 (5091 45 -----m7