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1991, 06-17 Permit App: 91003373 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM "lnformation Worksheet JOB STREET ADDRESS: S,„ R, 17 7tle ltie r ,K'1'1f1 ._.I - '•g- •,i-L CITY/STATE/ZIP: ,,o,e190 rc= ' '?Zi 1� PARCEL NUMBER: OWNER: 42.7" Ce a TQM.Lie id PHONE NUMBER: 92 y-- /10 2S MAILING ADDRESS: So I tor? / lter i.6 ,0 10-del 9q Z1 I (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 = SNC :;_ NS:::M:.}:.?:.:{-:.;:;;:.:<.?:.?:.???>:.?;>:.::.;?:.?:.}-::<:::._._._EN:.?:.;:.:.r:{_?}?:.}:.}}:.: x 25.00 = GAS WATER HEATER x 10.00 = GAS EQIIIPI ENT 10O 000 BTU NCt D>=5. «€`> >< ::<:<€: x 12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = G;:..A- >'PIPIN:, ; .._-.>_:>;.::.:...:.?:: ,> >'><='> > '==_ > >< <>'> >< > ' `<`> " S }?:?.?; :G.,{1=A OUTLET);;.:::;.;:.?:.?:.. :...;:.:.?:.}:?:::.;::.?:.;;:.?:.}::.;: x 1.00 = /-49 O BOILER/REFRIG 1-100M BTU x 12.00 = .......... .. ........... ..::::::?:..:>?.}:.??}:.?:?>.?;}: x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = .....(11 3EFR 1G..1i 0001.-1.750M:87't1..:=:»::: >:><:::>><: >:>:::>:<:: <:<:: = ..........r:....:...-'------::::._:::.:_::.:.�:._..::. : : ::, . :::::.:::::.?;;:_:::?.;}:-?:-?:.?;:.::.;::}:.??:-}??:.::.::�?:.?;}:.?:{.:::>: x 35.00 BOILER/REFRIG+1,750M BTU x 60.00 = >HE T PUMP AIR CONDITIONER »0-S-TQ[�fiS':':5:>:=:<$::_'E='::< x = ---. 12.00 - HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = = (IMP ,II# Ni IJOsgrf5- OONS x 25.00 = HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 . il .P, M : A.,IR,CO. 1DITIONER+5N TOMS .� { x 60.00 = : VENTILATING FANS A r x 10.00 = fx:;:vft w??vrx y%:n,•rx•:+w�f::N:.}.pfnv.-;;}-r.:{.^tiir{:i ::r=.`-::}:}.Ti:::}r':j:�y:::;is?;(:::-:-`:j-:Y•ti;:???{-::??:•}:r,.�vv?n. ::E APO.I. TI:V' :QQOLERS ::.f::•{ _ ::::::-.:.. x10.00 - '....:....:.....:.::..::: :.,..ter:::::__::: ::::::�-:.; TYPE I HOOD(PER 12' OR 12' PTN. OF HOOD) x 50.00 = vxY.:v::::::.v n-.{-�r1.k�� _.......::-rhl..�'„{::::v:::::v ::r::{n::::.•.,i? ?:•i:{•}}:}}}yry�.rr-'F4�:•� • A MOO CLOTHES DRYER x 10.00 = =1� +1 .1*->:;: ,.:.rte - .'SJtvii-::?:�m\{v:.{{iY:i�F.-"}iiv:'{?ice moi:::'}:?r{: ::�i'? X 1 . - ....:....:._.,:.v..:;:-:Y}??-?\r�ra.x-':'�4:`viiili::?:�:}:1 r?::?:-?}:.?:':riii:+}:i?-'.-v:i?.v:�?�.� GAS LOG x 10.00 = MISG LLANEOUS(NOT.COVERED ELSEWH EAE x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = :,v NNLIMW.('t.tA�10Ei4Qp t)0�►1 1"U = .: � .}:.---... v........ � ......... .:......:::>::: . :::<::>:::�::�� x100.00 USED APPUANCE<400,000 BTU x 50.00 = 1S0 .:::k:-:::hn !1..�o{-;nr�... }:;: ; ;;::<:;<:>:.: >:>:}:}<?; amr:rs: X100.00= AIR HANDLER<10,000 CFM x 12.00 = �.?+ai■fte.}•} : ?•:?;,F:.::.:}Y:�::;?:{'r,.:. :}•;: ; :::;:i'::i::::::::ii:::::�r::::}`.:}'::::::::::::•:•>:•r.-:•:•::•}}:•:}:.};:•}:•::�}}:..w .A.R. ANfLE.. : 0 ;. PM;:::::«::«::<:>::;::»»>:>;.:<::»<:<:»::<>":>;:<:::::<::<:............. .........:.r...........:.........R.;...1...:; ;G:..::::::?•::,::::::::•-=:::�:=::::::::.:�::�•::°.;:;.:?.:.,:• :.:.?:�???..�, X 15.00 = SUBTOTAL $ PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS:TOTAL PERMIT FEE DUE =$ SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509)456-3675