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1991, 04-15 Permit App: 91001758 Gas Log, Piping w0. /OV/ MECHANICAL PERMIT APItICATION FORM . /U-2-7-90 iInformation Worksheet JOB STREET ADDRESS: 7 / � // 1,,_4;6�(_)0;r• CITY/STATE/ZIP: ..�,DOKG,jf 1 c rra PARCEL NUMBER: • OWNER: 1�n &)U, -/,,,-g2:1 :? PHONE NUMBER: • MAILING ADDRESS: (Street) (City/State) . (Zip) • CONTRACTOR: L4c/ri 1,-c)0/0074„.SLICENSE NUMBER: t i}C fie/ ' /,--3./A-- i • :. ..,:•1 PHONE NUMBER: 53/0-&56/ ' • • . • • MAILING ADDRESS: P e . /dp?S ./✓rA c%' l.t,,? .. G<-14 5 2C)2-... (Street) . . '(City/State)• . • . (Zip) . . • MECHANICAL WORKSHEET/FEE SCHEDULE . ,'„`;;i ,; . •:wh»+•• , NUMBER X EACH . • • • DESCRIPTION ;".• : OF UNITS UNIT- ,.•• •: .= AMOUNT:,,, DUCTWORK'SYSTEM •.' • • , . . • •x$10.00 '- '''.••,:',••••":••••• •''''':!•t'• •• WOODSTOVE/INSERT ....•— .. .. — -• = — '' ,;,• X;25,.00 !2;t:,4,;...;•••.., . �: GAS?.WATER .HEATER • : .. .• x:•10:00.•,,,..,4 , .,�, t t: , ,Y , HEATING ;EQUIPMENT <100,000 BTUs-_ 0 A,..� . `J.'•7,J,. X ,12:00 , nt i,rri r> + 1 ,i`•. . HEATIN•G 'EQUIPMENT +100,000 BTU%�-a,_ ' - X 15.00 ,�. x' ;',t i r. '.n rti. . 'N,1 • ,.,GAS;:PIPING•• (EA •OUTLET) , ' .,.:,1 _ ...I.,: X 1.00 i;�i,;ti,t.�(�fJ r•};:REFRIG 1-1001 ,BTU (NOT A/C •OR HEAT.- PUMP • ,• •x 12..00 '.tL4S •• .,►7 ,•,, r• t , ' • .REFRIG 101-5001• BTO •..".i' ,•'; /1 + ' y1 ' r'.. h1 � .,— `k rt ., ,','+'yam../„ S{..� Xt20.0��'! Y+. 11�.!iiw.�iAi�_. 'yaw 'vy'�7± r �.;. -Z..°r, , <t ,•c;* X 25 OG s y's + r• t ,. ;REFRIG. 501-1,;00014 BTU_ x' _ ,�• , , r • �' ,� , c•., � . • �� ti .REFRIG '1,`001-1,.75014 BTU _ ;_, ,;•i!',. ,,',4.4,',... x,,35.:00,t , -J-•7f.<<.i:;:..0.1:t.41';;; ,� REFRIG:+1. 750M' BTUf:';•:. ! r , s i.:-.ii. r .,' 1 I .+ r•.] IY •;a . . * i .•. i` .�1-"` , r„ ;� �, 4 a1 �� .x::;:60.00 �' ,.1„�;«.ia� .,.� 23, ._,r. , . ,rt HEAT'+;PUMP.':&'`AIR -CONDITIONER:' 3,'rTONS f ,J`,�� 4 ►�,,+,+5,1 x, i��! 7C i?12 00'' ,: ..`"f,: ,..4•"� _.!:; ��',,,• t.,.. .$ . HEAT :PUMP.;&`Y AIR.'CONDITIONER'43 151�TONS,tfN},� , `?,.+wr;il,r,..1 ;�c. ::itc,20 004!!`YtFf r k, � , '. , ','' HEAT 'PUMP• • &'.AIR`CONDITIONER 15-30`•;TONS ' '= y ' _' .4,.,,. f"' cr . ..,!t;,:;•:,,,. ,. ,':, :,. ,;. ,.., x 25.,00 „ fi , �a fly ,:.HEAT••;PUMP: &cAIR'-CONDITIONER 30=50 TONS' ;"•r .'. 4•o k •'+" x1;35::00 ,+ ' ..0414.,�,+w.,� �'a' '.A ' `: HEAT`PUMP• & .AIR• CONDITIONER •+50;•TONS ' x 60:'00 A= ,��;k ...:; < ',..';•:.1;"> ' A • VENTILATING•:FANS.. — . `: EVAPORATIVE COOLERS . -- • _ • x 10.00 .= TYPE I:'HOOD (PER 12' OR 12' • PTN. OF'. HOOD) x 50.90..',=, .r • • _,., .I TYPE II •HOOD . • x: 10.00 = . t .. CLOTHES "DRYER . ' x 10.00 '_ , ... ►. RANGE • • . . x 10.00 :_ •• . t GAS LOG / x 10.00 is /0.00 MISCELLANEOUS (NOT COVERED ELSEWHERE)_ _ ' • x 10.00 - ': UNLISTED GAS APPLIANCE <400,000 BTU _ _ • x 50.00 - • UNLISTED GAS APPLIANCE >400,000 BTU _• ' • • • • x100.00 - USED APPLIANCE <400,000 BTU • x .50.00 .- . , ' USED APPLIANCE >400,000 BTU • X100.00 - AIR HANDLER <10,000 CFM x 12.00 - AIR HANDLER >10,000 CFM • x 15.00 is1 SUBTOTAL . $ ,' 'UJ I. .i. PLUS: PROCESSING FEE + $ 25.00 . EQUALS: TOTAL PERMIT • • NOTE: INIMUM PERMIT FEE IS $35.00 FEE DUE ' -' $ (30.00 SIGNATURE LiA,cQQJ.eJ 40-(1Q& • Spokane CountX Department of Building, and Safety 111....E 4'S ') n....�,.i....... n._-t._.-_ IONA n nrn it A Ir.?. wn.,r