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1994, 09-30 Permit App: 94009612 Mechanical Fixtures
MECHANICAL PERMIT APPLICATION FORM qty ( �' Information Worksheet JOB STREET ADDRESS:/ 5 3809 rr �/< ©r 4 i • CITY/STATE/ZIP: Rct h 4 A R? O ce+ PARCEL NUMBER: OWNER: et.'`f M,r 1 tit PHONE NUMBER: Y-44-j O � 7 MAILING ADDRESS: 5'4 (Street) (City/State) (Zip) CONTRACTOR: An ''C 4401 i cv c I LICENSE NUMBER: 4,VDIQ,E`M *)/31S3.3 PHONE NUMBER: /(,62 -73/5'4,0 MAILING ADDRESS: •t---75-163 L-}4 Lc,,f)11 Jig) 4 Q 4.20.7 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER I X EACH I DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = t•ih••..,v....1+vN'.,vnw.v,,.�w. / , $ /:C<: rC',�C, ti y 1.M41 a #1.. ttf 4 • x 25.00 = GAS WATER HEATER x 10.00 = IQ O 0 f e:a:e.. kgaffat :: .` f - X 12.00 = /2. (!) GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = .44- x 1.00 = 0 BOILER/REFRIG 1-100M BTU x 12.00 = 7'w++' :x'2:1'{?t�<n (��,:�'i.:l 'i a �aN,,, ' ? e ., s e '. '. r <} `. x 20.00 = • BOILER/REFRIG 501-1,000M BTU x 25.00 = yxry a:fir:S?.rsrr�,.::.env..-'p,%�a� ,0''• 4 4 B x 35.00 = BOILER/REFRIG +1,750M BTU x 60.00 = MTIMWMAIWAIMKg,W§Viiiaa‘2Y,:ix12.00 = HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = a I e x ?k x 25.00 = HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 = ga •b, x 60.00 = VENTILATING FANS x 10.00 = � � ` �`rJ � °"132 C`'SxY:�?}v:::::...'<'.f4n�+^C i. `»•5.::>:•.�.rs�.*.. x 10.00 = �.+�. :. .. :7, .,},ti-5: i,r:Y.r;.'A.�^:,:`ii...:.?::T..Xflri*?K, iyf,�'... TYPE I HOOD(PER 12' OR 12' PTN.OF HOOD) x 50.00 = •rte s.�� ,:?4>::�;��Ky., ;� ., a = ,�, '�,. ���� �°;:<��� �a��;:���rc �- x 10.00 CLOTHES DRYER x 10.00 = • w.y,r..c<: �ri `P�WW �i�S�jr:!�� Yr::i::�'�v J:;iii, �.�;+v ry�: P,xr ..... :�> �.f;?. f � J � '!:: ub� r �i5 �� xcX'RG�7d:Y??'7db�r x 10.00 GAS LOG x 10.00 = /0.0 cJ '�:Oar°.. •`.C�®:�s ` x 10.00 UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ••. { '• f B8 8 i '?9{'' ` = .:. ,��:' i � � � ���.r��;� � '' X100.00 USED APPLIANCE<400,000 BTU x 50.00 = ;Sterni WOR .3, : k ;N.n..,:.<•>.!:1,01 x100.00= AIR HANDLER<10,000 CFM_ x 12.00 = "i':'7•t-,.'S':m ,,,�.`i1.,!::.v)�:x�A!•.. fi�`� }�v'..• -9%rk•`.vx-....,�_„+�e-'�{- ` : AN � ,;' �I 3r'Q: ` i••`AM•. ::. 11Br g x 15.00 = i.,c't„•:::•::::�.:.,-:.::r:.;r... •>r .:a:,•x-::.r:::�.,..,o?k-..o:.:.,•:}.::::.:.:• ab::.r..••r..a:a•.:•,o:.r a;: SUBTOTAL $ 36,60 PLUS: PROCESSING FEE +$ 25.00 NOTE:. MINIMUM PERMIT FEE IS$35.00 EQUALS:TOTAL PERMIT FEE DUE =$ ! A-.) SIGNATURE Lc--C Spokane County Division of Buildings