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1992, 04-20 Permit App: 92002666 Furnace, Piping MECHANICAL PERMIT APPLICATION FORM I nformatiorl,Worksheet JOB STREET ADDRESS: /y0 7 l 5<1/ ORT<f- CITY/STATE/ZIP: 56/(4/1)L-5:- /✓4 PARCEL NUMBER: • OWNER: N/4 A)CO /3 PHONE NUMBER: MAILING ADDRESS: (Street) (City/State) (Zip) ••CONTRACTOR:NAT/0A) C/J/ar,t' / S'dC_ LICENSE NUMBER: NM- 1/O CS /OO A'R' PHONE NUMBER: < — dam MAILING ADDRESS: (7e/6, ge0, 19 )4,V S/' 4/v(= ,J/ (Street) (City/State) -- (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = • WOQDS f#P-flNS T €{s:.. ' :.°.n i<' r k{{sem, , { y t x 25.00 = • GAS WATER HEATER x 10.00 = :::::kk,:•::..•:::.,.::Ax:r.arti k. �.} �,ya�.y/� �,��/1 �•y i r !'4�1 0:100.kti ar i 010: 111104 r: •,41111:1;1•� •, i, / x 12.00 GAS EQUIPMENT+100,000 BTU ;DUCTWORK)' x 15.00 vaPr:. ti..., '•.iw.Q'}y{w..`.;•xi.,i'',:i.<xa:: t ii%;{iSti:ti<.r�,,• X ..1.00 = "^ BOILER/REFRIG 1-100M BTU` x 12.00 = :nY^:? •'�j:Lr:r::} 3 }x+W'•f7 :`,i} •n` i'i�y`if1.•• BOI . fIBF IG£1i1'Y51 [ ' > f £ ,. ,� $ i } x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = :Er : Y} C} i } i11 : e.J ,i: = : iun } " ,a BOILER/REFRIG +1,750M BTU x 60.00 = :I: 1 M.•:.:ciwv}1:}:.R:.. QQwbIP'iw nn*. jO E NSwv•?::i.r�..Y £ » x 12.00 = t HEAT PUMP&AIR CONDITIONERS-15 TONS . x 20.00 = • • ;y•. -:•:• ,:. x+ :w.. ,•: h. ... �:a.},.%::,•}:,}airy.•-v:}}:�^•. ,:}�;•,2"•:k,:�. H ' 'P4 II..0•i iA Il 'IOl l* 51.§11 a1:a .:}..{v }{ X 25.00 .= HEAT PUMP&AIR CONDITIONER30-50 TONS x 35.00 = {._.:i:::;ry::ry}:,}:}•;,v{:r}:ir,G:y rr,.•,.,•:,r;,c y.ri ,..,ri ro � :::iyr.,:..::.,}�:r.:gi,�•:i :^y�rr N 41 0 tf'< `AII :: ilitiP igti OTIM t l r <ta: : ::s. •x 60.00 = . }:.rrv.:v:.v.:� •x::. r.vvra} •: .v.. 7cr v. 3 Y...iC � ... ... t VENTILATING FANS • .0to A I v;rVCIT � valt{rrw «: % l.111 10.00 = itp��. dyi 4i TYPE HuOu(PER 12'OR 12'<PTN OF HOOD) x 50.00 = 5' 0.00 • r�h : :Fe. } :v::n: •fr ':v;�rf4S.,. i>,4�iv:hi;;.:.}:v::: .:iir:.v:rnii..}•::.:}i}i,•::n.., 4 _ `, ... :.rfi�v:..,hau a%vw.:v:::::4:•.i.�•};•i.4v:iii}.!ii:vv::.xv.•:n y:+ ::::::::.v::::::.v.•.:vvvvnv.:,v:.vv:x:.:• vv.. .: `. CLOTHES DRYER x 10.00 = • iii}::F;:::iY:i}e%j:•:.`,:ti}t%:} :::'F::ti:: .:o.::::r,i.::gz:1::• = x 10.00 • GAS LOG x 10.00 = IitLSG L ANEOU$ NQs.t:Q0VVt f.0 E $ERE >`R n' • x 10.00 =•• UNLISTED GAS APPLIANCE<400,000 BT,U x 50.00 = Y .•yv;,:yv::::n} }r;:.•t.,vv:.}:•}}:•?:•?:•?'4i?:i?:•::?titititi•14?:•??:• .'•?'i:... .:::::vn?}•::?i'''lvi}:,:::::: .:{•ny} !:.}':} rS rr .} }}}::.?::r\:i:ii.%r}}}}}:_:}}}}:r • ... .. .. ULINSTEI `G 1SAPPt,IA1" CE>400' !O*8TU >:r:<�: .:r:::<>::<; :<::<:: x100.00= ;:,. USED APPLIANCE<400,000 BTU • x 50.00 ::.yrryyii:•};:{+.•;:::;}::a:.}::i•}:•}:in}}}:a:•}:aba;•}:.}::.}?}}}:ii:•}}}}}:•};ii::?};} .. ::,a:..,:.».,.P?-`��`.i��'.``• 1�>:: x100.00 = AIR HANDLER<10,000 CFM x 12.00 DE .. x15.00 = ►.C .HAt`1 . . .R....ttlk`4:QOCIut SUBTOTAL $ PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE = SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 c' •