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1991, 11-08 Permit App: 91007687 Mechanical Fixtures ..,.._ . , r- - MECHANICAL PERMIT APPLICATION FORM , ,-, F.1 . '.; P(--q----9 c-Li 1-.9 6 I_ Information Worksheet LA - JOB STREET ADDRESS: -i '.: / ci L: L1' t, N CITY/STATE/ZIP: ,/,.: A C.1Z 6 5 PL:4 '7 9 C/(-7 PARCEL NUMBER: OWNER: ,My/on (...„ka,K t S.0 A) PHONE NUMBER: -2), LI - ,..)--(•,- ::›) 5- MAILING ADDRESS: II), 0, /:::::, r))( 5/ t7 /d4 96/ (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 = ... ............................. ........„...... ................................__„..._.„.,„:„ ,:_.::,.:.::.:„.:.,,,,.:.:.,....„..,_.„ WOODSTOVE/INSERThiMii:i:.:0:, ,m,,:: ::::z:i,:',::':',:,i,',::',:',:-::',',:,:,::i.:,'::,.:':,:',:',:,':]:i,'-:,:::, :,-, x 25.00 = .. . ......... ..,. ..... ....v. .. ....._.., ::.:: :::ix.::::::::i:„,::::,,,,, ,:::::„:::i,i, ,,„.::: ::: , GAS WATER HEATER x 10.00 = .0AS.Iii0.0.004.4ENT100;00011Att(.0.0,49.P.E$Miieliglign / x 12.00 = / ol 0 0 GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = Gqi?1p,ING'„:- E-A,fpt-Tr*g3)0iMiEiMiVagoi'Mi-igg'iNZ i x 1.00 = / 0 0 BOILER/REFRIG 1-100M BTU x 12.00 = %244.M9EgjitqlpAR,„"00KBIVzg,:,IiiigiiiEiiiiii8p;;iiiEigiliagiiii-i2 x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = ..:, • ... ,..... ,. ... . , , 1 E3012,ER/REFRIqj.:,;00011;750M:E3T.u:.i.i•::_ _ . :-.-:. . :1 x 35.00 = BOILER/REFRIG +1,750M BTU x 60.00 = HEATPUMR8:1:--AIR,CONDITIONER-03 TONS •-- :••••-'--::::-'--T.. I x 12.00 = HEAT PUMP &AIR CONDITIONER 3-15 TONS 1 x 20.00 = HEAT PUMP & AIR CONDITIONER 15-30 TONS I x 25.00 = HEAT PUMP &AIR CONDITIONER.30-50 TONS x 35.00 = fiEwriPUMR&AIFIZONDITIONEFF*50ITONSPK:" '"'''''''''' - - .x 60.00 = VENTILATING FANS x 10.00 = EVAP-dft7i:VE6.brilERSA''''i''':i°i''''''''i';''''' '-'g-:'-aa'W.:-''M'MMMaMi:1-4] x1000 = _...._..........,,..„-,..........-...-..,-....................„.............,, :::m::::,::,:„:::::::::::::::,::::-:-::::::: ::::::::::::::::::: :::,.,,, TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = 7.yRg1113H.QQDRSERIRE:Mgiiiiigggeig5ggiNgii:Wig-j! x 10.00 = CLOTHES DRYER x 10.00 = RANGE xi0.00 =- GAS LOG x10.00 = Miscp4144NEpu (NpTicoyEBED!ELSEWHERE- .]:Mi.': 1 x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ULINSTED;pAS 4p:14NpE]ipo;of,".',9 ETLi-::i:i:::•: :i,.:.,.,- ...::..:,.:,ixio0.00 = USED APPLIANCE<400,000 BTU x 50.00 = USBD.1::ARPLIANOE40c4000:L3TOi.FRR•f,i:;: gri:-VS1,- xioo.00= AIR HANDLER <10,000 CFM x 12.00 = AIR HANDLER --t 0'000 CFM- . ' • -. --l\f a V.:'A Tjak.'' ' > , . 1,•.'.:: -.!.. 1,:- x 15.00 = Sti:;-0iN6' 6 sAFE-Ty ,SUBTOTAL $ j 3 C 0 IPLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE = $ 1) () SIGNATUREic--°` U/' "\ Spokane Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675