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1992, 10-12 Permit App: 92008727 Furnace, PipingMECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: .5 CITY/STATE/ZIP' -',6 L. 7( 2 OWNER: J ONJ_-5 MAILING ADDRESS: 571` ' (Street) (City/State) (Zip) fit' • CONTRACTOR: M(�7V`/7Z C170740-17:-/----/ 7a�1ti/ LICENSE NUMBER: /(/i�- '7 C.S (C�l�`� r PHONE NUMBER: 49."--ZQOD MAILING ADDRESS: /✓ le /6 1' O4DLL 37t/ 96 Z1 (Street) (City/State) -- (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE PARCEL NUMBER: 1/S1, D'o� c L U/ PHONE NUMBER: Z(/ ' d6 J DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) �.t:5v:.tiv:4?ivrvi.7k/.:wV.` • A:{u •::-0: awX. fi v: .+• •n•�. ,�• ,�'' '' : "s •. GAS WATER HEATER v� "S•Wgen ,: GAS EQUIPMENT +100,000 BTU DUCTWORK) .p vrM, :y::x s„ t. .j 7.7,;, ;,ti, BOILER/REFRIG 1-100M BTU .50 BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG +1,750M BTU HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS Kiktittig- „.1 VENTILATING FANS TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) 000 CLOTHES DRYER GAS LOG .Qy�,��y[ ,y..i(;K: , ? .,y .wy:.,,, ,::.;• ny��n?Yuuw*}•xn xw(r y:, 'Jt��.•uh��llf��u� ' .. �;�1����pl.• {.:TI��' T.�\ vw�� . :.+ h rm{6.vuhx iri:.{v. :...ti S :•'r• •w{v{vv:v' • {vnv,SO.A : � �% :'. •x: ui' UNLISTED GAS APPLIANCE <400,000 BTU USED APPLIANCE <400,000 BTU AIR HANDLER <10,000 CFM yr00 `•r:45{.{..{4:? ':'r;w544.?{y5?4 • ti j i. :4{5.:{:}5:.;:;:••<•'tii+:•."�>{{r,{i::'.;:. NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x25.00 = x 10.00 = x 12.00 = x 15.00 = 'x 1.00 =" x12.00 = x 20.00 = x 25.00 = x 35.00 = x60.00 = x12.00 = x 20.00 = x 25.00 x 35.00 = x 60.00 = x 10.00 = x 10.00 = x 50.00 = x10.00 = x10.00 = x10.00 = x 10.00 = x10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x12.00 = x15.00 = • • SUBTOTAL $ PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE _ $ Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675