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1993, 02-17 Permit App: 93000926 Mechanical Fixture , . ., Q MECHANICAL PERMIT APPLICATION FORM 9 _ / / / , Information Worksheet JOB STREET ADDRESS: 5 7- / ea c ccJe.lf CITY/STATE/ZIP: ,S k4nE Ali PARCEL NUMBER: OWNER: f, be_r+- , '/�5' PHONE NUMBER: MAILING ADDRESS: M (Street) (City/State) (Zip) CONTRACTOR:, ��'OI?l� �Lj i k'7I e�/ clic, LICENSE NUMBER: AM T10 C5Q / PHONE NUMBER: C( MAILING ADDRESS:,/ � "ac � ► 5� .�� Cc,�t q/.z/Z (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT x 10.00 = ELECTRIC /DUCTWORK(SEPARATE SYSTEMS) x 25.00 GAS WATER HEATER x 10.00 = `::::ri:::::: / _ ���: ��.�}fit,...,..;S-��^.R7:,:}::.•:..•.:.�::::............::::::. :r:::.,v:::.r:r......,.,.r......::.r:rr}rr::...::. 2 0 - ',.....,.....,.....=k--:. AS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = �t�A�c t'(�t x1.00 = ?�:{>'::}<:::.},,::::,:i:,:iii:: ai•i:}-}:i?i:,,:;:>:i:,.t:,:>::<::.:- • r.•.,w.v+x..•nAv:nh�.yr:A.,:.•:nvvv:n • v:4X..:��Y••..'r:{:vv\. •••••• BOILER/REFRIG 1-10OM BTU x 12.00 = •},.:;;::•,;s9n•.v},y}•:yy:•r--::: r,f:::::::i\ti:iii::ji::is:i :::: :K:ii?':?:L{::{::::; >:;;:.:sY>}i:::: :::>.:<:»:>:;}::ii::i:: :>:>ii<<:..::>:: x 20.00 = }.},.::,: 100000 Bim.}::::N:*::::;':} •••:;}:.i:}:':i}::.:.}::.{.::}:::.}}:-{:.ii:?:> BOILER/REFRIG 501-1,000M BTU • x 25.00 = << «<> = :..�::?i::. x 35.00 BOILER/REFRIG +1,750M BTU• x 60.00 = .v�.}tl}vv. Y..1...:M.:{1.,.yr:{.....x,.,,,{:::3v,,.., ,,,.."."-yo 71:::,. .,::nvjt....„:::,:::„...........,.......t...: ::„.. i ..,.. ... 'Real ::1„•-s,:‘,:••• :::----`tr�:y !+�tryf •>.�:�c� ?: .:'.'.-..TO n+ :'?.'}.s: ;':•:. :a :> : x 12.00 = -...• i„}4 ': -3l:.1r 131Ya`hl-r:�,rh::,a:::f.:::-h-r}::::::r::•}::::::::r.-r a;w.�:. HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = r vv}q•..:M'rv.}?nv AIR. .vn}•:::::.r::.f_._.•:r,;:: w.,..-n}.1.1, vv, .:.}:;:j:}i%ry{.{},Y•;;.;?{ = .rte�++♦♦,,�� ��..yy■■ �(E ��♦7 ! ..' ' .�:-;'.•,•-''.. > C` �>%' £> z>: x 25.00 .S;A; .}v'II i l t 911-,•}.vh vrynv„J.v::nv:.•.•::x+.{•:.v::.xv.•r::}.v:::.vv{Choy.}r. HEAT PUMP AIR CONDITIONER 30-50 TONS x 35.00 = •{a}• r:{l}.: xry::t_:::r:{rrr{rr.,,i, my N:r v.•Ax,.�}:nyr. : :{ry:;i':i%::i•`'F:i:: :i:CF}: =W ta` .y/{�� :I:. kryi ' 'I •{�.`N:(:,W.�. --�f: :::t<.': .?fi?:,'<:: x 60.00 i,:.t •t} it !�:{ k...: .{ i- ;.:•:-v ).{l.� IX:.:::::::r::r::r:::x::::n4:.vx:.:::.v:hfin?•} r. VENTILATING FANS •• x 10.00 = yyy.� ::,•- ,..,:y; .. . .. �>:l: .: .w'<;.i*:m.:}<:i •-• x 10.00 = ':::•:•:::•:.} :.�rii/ '•rW':•.•i: ti•.; 3} i;ii:%v:�'v� t]Cv:i}�},:n�}f:iv.:'ri}s:{:::iii::?:iiLv$:{riiii::iif.CZvY.:n TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = '::i :=:< iir:::i:::r,:r.{::{:::i{:': q i;{:?.:{}:,}::.::.}}:.}:.}:.}:.>;:}:;i.{>::.: = l.}}n:r:i0T...,: 4:.4,f::{ .:{. {'-:{::::.. .:h{::ii..:{[L:: x 1 0.00 - :•v.v.,{'}}}}r{:;:.:i+i}}?}:- }...Y{i ': :is::'.:is::i::i:-i:- j}:::ii{':'::i'::'v}:{�. •}:}...:::.:.:•,•::{Y:;•.{,•I:}::::•Myr:?{�•:::v::::::,,?•::.:::�.�•h?,�:?•.:}}fi:'�{-.v:.n...........,..................,,..n.{r.{.{..... CLOTHES DRYER x 10.00 = :iii:;. :;:.}:.:.%.: ':IlAN:��^{:::}.. ..-:....:...,.v::..v..v.:r:•v..:::......r...:........n...x::,iti,,,:}r::f%{i: GAS LOG x 10.00 = ``' ti '?`<` = ►' :'><...,.. x 10.00 UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = x100.00= x 50.00 = USED APPLIANCE<400,000 BTU x100.00= AIR HANDLER<10,000 CFM x 12.00 = x 15.00 = SUBTOTAL $ PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE =$ ZSIGNATURE `l/ Spokane County Division of Buildings \A/nct 1'2(14 Rrnar4wav Avon'um Snnkanp WA 992A0 (5(191 456-3675