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1992, 11-24 Permit App: 92010350 Mechanical Fixtures 4 MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: t ( ( q i ( Se.) At AA• '12Fi,t."Z..n o...ou Kr . / 0666 CITY/STATE/ZIP: �j P4,G..► "j kibt- z-(4. PARCEL NUMBER: OWNER: R ' - •n " Vc r PHONE NUMBER: q 6124 MAILING ADDRESS: 6"-"A.ts) (Street) (City/State) • (Z1P) CONTRACTOR: T2 ' lievkl:: cco2 Pi-$4Ce LICENSE NUMBER: 71)?i-IAt-6.1T6 Vb& PHONE NUMBER: Q4c3 -31 MAILING ADDRESS: S. t30 R `T SPoK►4/ wP gtgZo2_ (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE,•;,,,,,,, ,:,;,.;;,.',.:., NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 ;<r>..:.. :k.r..:,v>{:,fx{' }•gh,'•;iv';',i�w:..::.- x 25.00 = yy!: yP. : Aiig;:�ri•:�'•}. \ ,:}f.,{:i�:::v:4:P:.i n:riiii:{iii:?::-iii 4:::.:?:-'vti I {siTi��'�. �� � �T!l. i>:i::.i>ii'{tiv:isii:•i}:$'+7-{i}i:}�:::•i:•::..:. ... {4:S^i::{:.i:v::-....... GAS WATER HEATER..: x 10.00 ,. r.. . 4 :f >ti::{':{_:;::>,->r`'>: x 12.00 AS E�l:�tl�Mll.N'C.> Q���t <�'�'�tt' .l`��ts1�, �.i�,�;i:i::i.--....... 4, +100,000 BTU DUCTWORK) x 15.00,.fish , :' ,, GAS EQUIPMENT - T .4v{jf:: {A:?i{, r yi4ti,{{•:. / x •1.00 _ ° / ---- •.5;52„.. :. 4 •.�:bv:• 'vii':i:v:::v:: 47�{ r; 11��( s { t{a 4 a s is ccR{{b .: ... .....,... BOILER/REFRIG 1-100M BTU... x 12.00 _ } }�!I .J/ 7j /7 T ? } .r}4isrr ' x 20.00 ' i:, 1;, ii0. . y}:.av ,••grill, ::i0: 44.0 -. ..., ', Y.?^{v4-Y..\.{.^.{{:i::'rijiiiiiiiiiii::4:,i:•i: . .....!� w::::nw::xn{w:::::::,v.n,......,\.x.., '4]v.+.:x.:i BOILER/REFRIG 5011,000M BTU x 25.00 t(RAWAfitffallitiol '<:;::;1'$' {.,.{{:::{>.<i::iii:, x 35.00 =. {rrK:"+ ...?:..\rY:n\:r{n},n.:.....-.-,w::nv:n: BOILER/REFRIG +1,750M BTU x 60.00 = 'ti:.•-a.: , l.. I.. TON R'0-3 T Nom' ;}::::::>':':::: ::::: x 12.00 = HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 :H EAT::PU MMPI .:AIR C DIT N Eh i 5 .30►'CONS .,,,,... , x2500 = �. . HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35 00 = .. w:;:i:::::x:>:::::<.ii:<ii x 60.00 = .''• �`I�o1.�R:sI�::AIRS !�! b(Tt1�1..:��`..Nt�..,o.�`.Coo£�;:{:::�i:i::<::;::::>::»:::> � .�.,;: . VENTILATING FANS x 10.00 = ':A: :. .:. : .{:... .. x." ?�.:~f.:<.::;:i:::::iiiiiiii:;::>�=::�:::>�� x 10.00` _ 1, .. .i .. -i ��:. w::::x � 44h;.i:Y.:{:{:lip,:' :CX•.I� .; �..::�:�. ......R�::i:`.::if� ;,•"�>Cyj�?`r�lr G: -:.:-....::: TYPE I HOOD (PER 12' OR 12' PTN OF�HOOD) x 50 00 . :'i;•\••h::'i.�:rn•ii:-ii:i:4}ilii'•:{w :::::::v'?::.:: = .,,..yy;{{�� ?is4:i{v�}?:•i:}4iiti4:•}:{i{•ii:i::iiii{: ?::ii•:i:G':i' X 10.00 , '.LJ.{::{:i::isuiti::�;::?:isti�::::{:�:':}4;:j�!'i~Yti:::t��iC:.�:...::::::::'vw:::::r:::n....:n-.:.:rr...:::: -. CLOTHES DRYER x 10.00 = ' • .ILW:.. - .i;:.::-:::.>::;:-;::;.i;:p:.i.:•:.;;..;{.;:•.;::..:i::::.ii:.i:.{:.. ...:....::: x 10.00 = • NiViNE ii.: �' ..i::{:iii::?:-iiiiiiii:iii:+.v:'i'i'ffi:i}�iii'ti::: �::$:::.:.ii:::id^?.:i.::::y -~� �: . r fi r .:.rr::::.::.: ...........:.: . GAS LOG PoW../ WimL rk:: . x 10.00 �= , I '0 ilmtsoteaNtoovi ;: . EDE ► < x 10.0 ; to` UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = UUwoltR11SP0ItN00.....QQ10001Xin:::: :,.::::...... x100.00 USED APPLIANCE<400,000 BTU x 50.00 x100.00 AIR HANDLER<10,000 CFM x 12.00 = qtly HANIl „ ?;I?i :: r :;:i::{.>: ........ ... ...... x 15 SUBTOTAL $ PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS:TOTAL PERMIT FEE DUE =$ SIGNATURE 4„g,,,,,,f0_, Spokane County Division of Buildings ' West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675