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1991, 09-05 Permit App: 91005556 Wood Stove MECHANICAL PERM;r APPLICATION FORM Infornat c; Worksheet JOB STREET ADDRESS:_ 5,_36ic%? 5Lo,i1 -t/'L1►AAet• CITY/STATE/ZIP: Spo/C/-�vr e_ , L J'/ er9,4O1i PARCEL NUMBER: OWNER: bAUil.1 PHONE NUMBER: 9c`/ `e'.565 MAILING ADDRESS: 5erWu2 Ca (Street) (City/State) (Zip) CONTRACTOR: r a )CA G 4r2J E.jJ CEA.1 f Eg LICENSE NUMBER: Ft4IC0 &C,1-7-3 D LA PHONE NUMBER: (50(4) Grog"-g9I I MAILING ADDRESS: E q3) b Sp eA3L(e. S , Hsi ),Jr6 942 0(o (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION' OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = NODI' ,S'.I OVEIINSERT -:v ,:'->,>:{,.:::{;<{•:::<'=>:<< }: , S ) x 25.00 = c95.0D GAS WATER HEATER x 10.00 = .�.,,N-,, .r.,-:::.,Y.,;:,::N:.;-.r:. ,.,,rNs,::<:�::;;�;: t�<nn,.:;;,:,v.} A; Q IPMEN '} 1O4 OO ►STI QINC x4 x 12.00 = -,w,,..:�:.,,;,}. . - .. ,�}:� > .,.-. ,•. ;v .- • GAS EQUIPMENT+100,000 BTU DUCTWORK) "' ' X 15.00 _ • . - -.... rh?v;f � 3:,n.-'ur,op•.}}Yw..{-•:r,,.m «-x;::r} G'A •PP--•I.1..-a OUT.L � .<.{,.::;:; ,'r: <, }f f . }.�::<a,,,2:w•.::,.::s �ew---k�,.c<•' -- >�,t <•..r�sc nnv„c:,•ake....sw:-:� - BOILER/REFRIG 1-100M BTU x.:w. x 12.00 = x- .r + �j��1r( - - _ a f � vY:v kv4klt�i:: BOILER/REFRIG 501-1,000M BTU, ; .-,= --T • x 25:00 -M B � .� x n t �a.•v.exa�n•s BOILER/REFRIG+1.750M lSx 60,00 y, La -0 �� `;:4206SHER::b` 0 �"��,}Sex12.00 _�- HEAT PUMP&AIRCONDITIONER 3-15TONS -1 ;i20.00777:17 � • ..�..` �� WM ,z° 1V:C+ 1.°110-14:- ' ° 0 n x 25.00 ''''';";'•H •TPUMP&`'AIR CONDITIONER 30-50 TONS =�' 1 ; x 35.00 sr • ,M II CO:•I� S - - x 60.00 VENTILATING FANS " • . x 10.00 3>- :•:ESS x 10.00 TYPE I HOOD�(qPER 12'OR 12' PTN.OF HOOD)- ::--;f±,---;- x 50.00 WC-7211°011 �.j ��FJ�'�" Iry ?^--}imii{�.4. "]Cgo-";v=�?L ) _ _ _ f vv -T't-;:5::%w.-:�C4- ->CYii}3:{4}?:tyv; r�:iv:}-i:r-}:'.v�+�r-.•v:•.-:-�v'I.: .. Y WW'-��<•' C-72•y!rl.:s,•'iuF::r:'-rM0i} ;4}:'::w:'sy''.c f::-:}?'-,s,:r.ctiCc'?.r,}}::{:.;.::.}ri: _ .. x 10.00. • CLOTHES DRYERS X 10.00 = - INNEMMEW v.:.< .,::vsv.EMe.nta ..�;:, `..v.._ x 10.00 GAS LOG x 10.00 = - •rx:ryyv:-v:.v:ry{:-}v;i;v.•rr.::;::nr�n+w.wmr:r::n{:.ur:Ktrvw};:n}v:r;:mry ::nv:. MISCEi.1_ANEOUS OTCOVEI EC ELSEWHERE------• x 10.00 UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = UUNSTED GAS APPUANCE5400,000 BTU x100.00= USED APPLIANCE<400,000 BTU x 50.00 = USED APPLIANCE>4 #000 . 1111,.:>: - xt 00.00= AIR HANDLER<10,000 CFM x 12.00 = OLE . ,:,.. �..;:"."<�> _ `< < ><>�<=><:>:> «>=>:::<:>>�:::z<:><:<><=>::::><:::>:::<:» = R tl FI3j.Ao01✓FM.... ;:>::>;::>::':>:::>:::::;:�•�4:<:.. ........ ... ...:. x 15.00 SUBTOTAL $ 05.UC PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE = s SC. CO ..NATURE Spokane Count? Division of Buildings