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1994, 01-05 Permit App: 94000117 Water Heater 140-0 t4. •P5 ce ,1!)? MECHANICAL PERMIT APPLICATION FORM 611-1-113 61= €.4- t-icf.2. isekti, 1-73 Iniormation Worksheet REET ADDRESS: ii/./.5 o , c-- -- CITY/STATE/ZIP: C'-7 4: .-t,-.. - . PARCEL NUMBER: OWNER: -,1. , • -ri,Sa ri. PHONE NUMBER: -. - MAILING ADDRESS: .._ .:.,, (Street) / ..LCity/ tate) (Zip) , CONTRACTOR: A ' .' d - _14..4 t-c! 0 _ LICENSE NUMBER...AL :el a_ j-/A.1.26J. / ii,/ PHONE NUMBER: MAILING ADDRESS: k ..L.L.a.. -- - S,L1-e-La.----.)--L) 4-- Y 9, / --- (Street) ' (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE r NUMBER X EACH DESCRIPTION OF UNITS UNIT = AMOUNT -ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 iv , ---.7sfimmiiiiwiaimio::.:i:.,:i:..-:::,::::,:..,,. :,•::.;:.;;.:.: W.OPPOTOVEMS:g01 '*'s,;:,,,:,*i,:*•,,,,:!,,,.:m.,,:::i:,i,:-:',:, :,'::,:.:-',,,•,:,::..', ,,,:,::,'.',',',....::-::.: x 25.00 vs _____ GAS WATER HEATER . ........._ . .. .,.. •,..., / x 10.00 GAS ME V NTVOMO: ilVic14440glitiEll _ x 12.00 = GAS EQUIPMENT+100,000 BTU ,DUCTWORK). . . ...,, . . x 15.00 la --.1 p:,. sotwt..t#K0ttttAtjgIggitigalli.ni:A2i:i!'!:.5B,ggl x 1.00 w, BOILER/REFRIG 1-100M BTU .... x 12.00 vs I -.1 f3.0i4.410t#04#1..t.4100101,1,103gi:;RialiCigi x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 . B.OIlLEMItPf#0000P1,M.WOIVITCiiRiPiliiMIF x 36.00 = _ BOILER/REFRIG +1,750M BTU ...,‘......,_....., x 60.00 = _ HEAT.:::PUMRIkAlf(0)IVITICIIIIM04!.1700ii.ii$Saiiiiiiiiiii :., x 12.00 = HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 s= 11 -ATIPUMP..:,r&AIRION01110110111$4$T0002121 x 25.00 sv HEAT PUMP &AIR CONDITIONER 30-50 TONS, .. ....... x 35.00 = HEATPUM.R.:4'AIR::PQNOITIONM4i 450TON.$...:i!:RiiiiiiiMi:iiii : x 60.00 = VENTILATING FANS " x 10.00 = .....................................,....,.....:..,,:....,.,.„:„.,.:.: EVAPORATIVE:POQI;ERSaggali!Mia.:::1X:Niii::M::!i4..;!11;]:::: ;;], x 10.00 = TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = ....„... .. .............................................. .........,...„...„.......„....„, , .. TYPE:.11'HOOD...;:lriii :Ri':':':''V:::E!'1, :kii:::!1!!1%., :triliVIR! ':::::::::r''-',':,.MiCa'l x 10.00 . CLOTHES DRYER x10.00 = RANGE:H: ,:: ...': ': - 1::t.:::'•:' '!!'1:::R:i'' :DC,::.';' :::::iPlEi'i''';''''': 1:-: :::: :.,::;:::i''''''°';::i:':;;.''' x 10.00 . GAS LOG 10.00 = . .. ..................,.:... MiscELLANEOUS!INOT,::! 0Vg.FtP:.:0.$tEWHaft41:,izi ,:::: . x 1,0.00 UNLISTED GAS APPLIANCE<400,000 BTU x 50200 ULINSTED.GAS.APPLIANCE.: 400>400,000 BTU'' ::::=:A.,i,'•:p ,:in ..'E: : x100.00 . USED APPLIANCE<400,000 BTU - x 50.03 = r L --- - u s ED.i.APPLIANCE. 400;000...BTU-.<:::.:::-:: :H!'.. H. :1',': :,ins.:=.: ig:e) x100.00 = * .....____ MR HANDLER <10,000 CFM x 12.00 = „ . .. . .. • . „ . . ... _______ MR HANDLER. to,004- Ftki.•.:H..,:.,ii,,.:• .: E,:r=,E'E.,.::.,'•:::.:i'r....:.::!,:i..., ,:',::::i;'::.•., _.1 x 15.00 ---ISUBTOTAL .4_ 5 jO,0 0 PLUS: PROCESSING FEE I 4- $ 25.00 NOTE: MINIMUM PERMIT FEE :S$35.00 EQUALS: TOTAL PERMIT I FEE DUE . , . SIGNATURE Spokane County Division of Buildings woot 13,-,.,.... -1, Avenue Spokane, WA 99260 (509) 456-3675