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1991, 11-13 Permit App: 91007779 Mechanical Fixtures 41.1+k-' r ', rnf v;pa • tr.., .;+, ia t'�'.et': '...-,-.,!:.4',' ,."- '•.:!4:14,0,;,441-:•, k .4 4h!4:. -., . �,*a MECHANICAL PERMIT APPLICATION FORM : -' Information Worksheet •:f;� • ;`. • JOB STREET ADDRESS: e [. - � /''c ' ' CITY/STATEIP: PARCEL NUMBER: 3 G' %''- b ji .2 OWNER: iC 1< - 11, , PHONE NUMBER: , MAILING.ADDRESS: .- , ;, (Street) (City/State) '' ' . : ' • '.• :','..-., ..- (ZiP) CONTRACTOR: * I LICENSE NUMBER:, ._ . PHONE NUMBER: _. . MAILING ADDRESS: $,. '_•. . '.. (Street) ,(City/State) _ (zip) MECHANICAL WORKSHEET/FEE SCHEDULE • NUMBER , X EACH DESCRIPTION ,• ' OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) X 10.00_,'01.::,,,,.:, : Mg-0q$,, VEI;I SEI1 � < �:3 b 1<: X 25.00 =*: h, - ,l;' ` GAS WATER HEATER • < Y u dat Iw.�'}}--': 1 i i'`Bfe i. SIJ ���#1 x 12.00"�tl d_` 1.t:'5.i ' : GAS EQUIPMENT+100, 000 8TU bUCTWORK) x1500 ' r ` •GAS PIPING �' �,, ,...�.;.5..;:..;•.::::.;:::<:>.:>�;:: ,. -.�.............tcc,.,......�....:::..:::.,.::::::.�: ° •r7a.a .r,q. `�aaa••c`tQi: +S}`,..v}{ r' ?t£�.::' ��: X.1 �. !.t' � ..; iii ';.t..•• •.:4-.41 BOILER/REFRIG 1-100M BTU 's �" . ••••• X1200 `i. `; ' SC 1I t a. ge #.. x 4 Wo. I 'i, e gdh agati ... .,.{ .' 20.00 • 44 BOILER/REFRIG 501-1,1140M BTU x 25.00 s• A , 14., :::.::nv:r : : C)1 t�, 0k.: klita. •�: t: ,' E 7 , x 35 00 : r} i, a �, i, BOILER/REFRIG +1,750M ETU : y :,r, . . :. .x 60.00':-=':::.',4.'" -;4.7 "ko rrif HEAT: ' .t &`Alli Ct N itl tiNA HEAT PUMP &AIR CONDITIONER 3. 15 TONS x20.00 = •,-.,,.. , •104..,'# , • • HEAT;PUMP&AIR CONDIT dffiE 15.3n TONS.............:. ..... :,.... .. ....} x..25.00._ s , , HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00'= <HEAT PI:MIj&All ' ONDi. 'b T ::4€,:::<:3 : , �, 0 ONS } x60.00.:.= g• ;t . Y.-.�,oo-:.�.::...:.::::: ::�::::::::::::k oar:»rsof.3" wN:.,o k o Sr:ae.:.,}:}.., � r : . ...........:: ..,. :� t,.:..., ,tis .,�:•"' • VENTILATING FANS "" X 10.00 = EVAPOITiVE CQOLEI • > ' : :x.;ifi •:. ;: ;>}. ;:4:>- .:: n<: . .... ..}:.....v .....ti:,:: �':Y. . = :.; ,. .;:��:? :><:>:<: ......... x 10.00 :� • TYPE I HOOD(PER 12' OR 12' PTN. OF HOOD) x 50.00 = ''- • TYPE:11 U' .;:si i2.:.;,}}.r`:::j:'.,:oifi::.''.jv r.:`:`?::: �y � }XS{l,',aEn �k > .............. x 10.00 _ , �, .s ' , i CLOTHES DRYER x 10.00 = ` . :., i • X 10.00 RN , . : : : }sr � " GAS LOG ' • x 10.00 _ MISCELLANEOUS NOT.COV I ED E(SEWHERO • x 10.00 UNLISTED GAS APPLIANCE<400,000 BTU x 50.00` y; '''•- < , ULINSTED GAS APPLIANCE>40000O BTU.:.. .... ...: x100.00= USED APPLIANCE<400,000 STU x 50.00 = 'USED'APPLIANCE.$4003)00 t7tUr`.......i>:`;< ':<': >`>: ::: x100.00= . AIR HANDLER<10,000 CFM ''- x 12.00 FAIR HANDLER>10,000 t I M '} " x x 15.00 = /3 _•' SUBTOTAL $ ,fid'_` PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMI FEE IS$35.00 • EQUALS: TOTAL PERMIT FEE DUE _$ 3‘r SIGNATURE Spokane County Division of Buildings • West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675