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1993, 01-14 Permit App: 93000145 AC 4 q3-- / y5 MECHANICAL PERMIT APPLICATION FORM Information Wory shout .. / 39-a gi-mr. -JOB STREET ADDRESS:__ ! ' L , j • . CITY/STAT ZIP: 1IJA iY� 'ti ' c C ,_ PARCEL Sir MBER: OWNER: ,. .0_ -vrr__�r�-� PHONE NUMBER: 9, I 5.73 r,2 MAILING A 2D-ESS:Sa--_ J (Street),,,, (City/State) (Zip) CONTRACTOR: 29-_ .th f, ie L LICENSE NUMBER: IU�-�RE FN0iL5�.,1' '� `J PHONE NUMBER: 9,P,--2-/OR 9 MAILING ADDRESS: K-0. l £/3W7 4-)46L44z.,� 0 ) 9\ _.9 /3 Street (City/State) Zi ( ) (zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = ....................................................................................................................................... x2 = :>aaODS . : ; 5 00 W TOVEJ.INSERT.........:.><:>:>>> :>»>: >>�>::»>:>:: <.. . ::::.:. ::> GAS WATER HEATER:.,..,•:::............................................................................ x 10.00 = ........................................................................... GAS EQUIPMENT<100,000 BTU:(INCLUDES „: x 12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = 4AS PIPING EA QUTL < :`iiiiii.:' "':':>:«.°..:: . .. .:. x 1.00 = BOILER/REFRIG 1-100M BTU x 12.00 = BQil.ER/REFFiIG 101-00M BTU ...,,:.. :....... . :::....::I x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = BOILER/REFNIG10O01-1,750MBTU : .:..:. :......::..: x 35.00 = BOILER/REFRIG +1,750M BTU x 60.00 = .HEAT PUMP.& ►I t CONDITIONER 0 3 TONS I x 12.00 = % 2.00 HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = .H:EAT• PUMP.&AIR .„...•,.......................:•.••••DIIOR 15-30 TONS :..... <> x 25.00 = HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 = HEAT:PUMP&;MR CONDITIONER*50 TONS ......:... x 60.00 = VENTILATING FANS x 10.00 = EVAP9:RAT OL. RS x 10.00 = TYPE I HOOD(PER 12' OR 12' PTN. OF HOOD) x 50.00 = x = ..: PEI10.00 I .HOOK.>�<'<>< <> > >>><:«... CLOTHES DRYER x 10.00 = RA x = GASLOG:::.....n:.....v.....,.v....,.......:..:.............................:............................................ x 10.00 = .MISCELLANEOUS(NGT COVERED ELSEWHERE ..., ; : x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ULINSTED C,AS APPI!.IANCE>400 000 ETU .... .:: x100.00= USED APPLIANCE<400,000 BTU x 50.00 = USED;APPL IANCE 00,000 BTU ;>>:>.';:; >:: .... ..... .. ........:: x100.00= AIR HANDLER<10,000 CFM x 12.00 = AIR HANDLER„>10t0Q(. CFM .....:... ..... . ....'::: ....:::... x 15.00 = SUBTOTAL $ raj.cO PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT 1 FEE DUE _ =$ 37`Q1) SIGNATURE • '+ Spokane County Division of Buildings \A/....• 4')t ��......1....... A........... Or...I. .�... \A/A AAACA /CAA\ AL'L• ' 71