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1992, 10-26 Permit App: 92009323 Wood Stove MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: /208 S ..1-c-X-7 ti' t,__ eqc CITY/STATE/ZIP: Spok01lQ Wgs/t 9g2/z.„ PARCEL NUMBER: OWNER: cite yk7 /-QCq A& PHONE NUMBER: /Z7 S 7/g- MAILING ADDRESS: /20e ,$ St [r t e. A, 5- ,.4pe (,?Ai 790 z (Street) (City/Sate) (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/DUCTWORt .;(SEPA:;=;ATE SYSTEMS) : 10.00 = -:..::::; .:::::: asL B0 1NOODSI'QVEIiNSERT <:-.::::_<::;:,:..:::..:. ...:.:.:..:::: x 25.00 = . .... .:::::. GAS WATER HEATER x 10.00 = GAS EQUIPMENT<100,000 BTU NC .UDES _"---__RI' x 12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = GAS~PIPING. OUTLETa:. ... x 1.` 0 = BOILER/REFRIG 1-100M BTU x 12.00 = E3OILER/REFIG X01- IVt 1 ;:-:;<:>=:::::`;.: : :::`::::.:;:` :' x 20.00 = EOILER/REFRIG 501-1,000I --rt= x 25.00 = pOILERIREFRIG 1,0001 "• x 35.00 = BOILERIREFRIG+1,750M BTU x 60.00 = U PR OD NWIry; µ x 12.00 = HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 _ E,'I'PtJ. A AIR OIDIA'#O IrA { ryNS>'` `."=`! x 25.00 = :EAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 = U10AI# CONDITIONEI +5( T(&.:<:?:<;�.:::;_:_»::>ri: x 60.00 VENTILATING FANS �_:. Y x 10.00 = NEVA y «:r>:-.. „�::},n _ . .---- r:r�:.,-::::.-:::::::::::�::M -r;�?:>;Ks��,.�-�::> ��:-..�; .�EBBitit x 10.00 TYPE I HOOD(PER 12' OR 12' PM.OF HOOD) x 50.00 = :- :rn.. :':1.V:M..:'1..: R5?+hi?.{.-..:iiif:}:: viS: .vrS.vv._.. _ :nr-.e = �4:v:.?-riw:.:xxvv\-rM: �s:�r:;<:;:<-:�:»:?<:v:>:»»::•.i;:..i.;:::,.�<;;:�:::,-.. ,�,rn:. �::::-.._r.:. ?>�- x 10.00 CLOTHES DRYER _- x 10.00 = _-- - T}:I.r:YF.!�itivM:?iiii::':si::::b?iiiiii::-:h:._:i:i:_�:is-.?::-ti{:i:-ivy:-+?�:x_ri?r.:n::iiufi-:�::,?{-:ir?n::e Y.mi}i-•. J.• --- - i4'fj}?i?:-v-L:viii':Y(}-}}":-.-r-r-n- - ..,�-r :�r:::.?-;:: '� ........................:-.....Hn...n., ... . :.t..{a....:; : x 10.00 GAS LOG _ -- x 10.00 = ............:.............. ...::. . am... . ...:: > �_ :::<:>.;::::-;<;:>. x 10.00 UNLISTED GAS APPUANCE<400,000 BTU x 50.00 = U.UNSXDGASloomNCE O0 81(3 .r>t x100.00= USED APPLIANCE<400,000 BTU x 50.00 = -xIggqApintAN...... ...................................:.: 0, :sT#1 ::::._:::._::._:::::::::::n.::mme x100.00- AIR HANDLER<10,000 CFM x 12.00 = R HowDLEI motiola ......... ... . . .. >::>::::: "..: x 15.00 = SUBTOTAL $ 2S:Do PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE _$ S,o0 SIGNATURE C_._- '. ; .•j' Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675