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1993, 05-12 Permit App: 93003429 Piping
MECHANICAL PERMIT APPLICATION FORM Information Worksheet q JOB STREET ADDRESS: S 1509 University is CITY/STATE/ZIP: Spokane Wa 99. v6' PARC:'L NUMBER: OWNER: Art Ladd PHONE NUMBER: 924-6815 MAILING ADDRESS: same (Street) (City/State) (Zip) CONTRACTOR: STIIRM HEATING LICENSE NUMBER: STIIRMT*210(.F PHONE NUMBER: MAILING ADDRESS: Spokane Wa S 1509 University (Street) . (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = gy�pp// "::2;:a`,•:.{a�;:;};?; {!? ;,: •::s:?•}:.;. %Y:Y:.y ...-- ' .. .• ;:::;.:;n;.?::::"`.:.;;{fi ,?.{.:}:x.n;\,.tr{.,y;;i%s:;ij;`. ; .sti:#$ :' :`:.?{:;it::•r = .-....�� .�'s�'�:-:fi.�f,I.•.,•.t�,,.�,.>�:�:�'?. :r;�-::::t•::;«-;.:fixi::fi;:.}:} ::::::::::?::<::-::':::.-:::ry;,ryn::::;;>::::: x 25.00 GAS WATER HEATER x 10.00 = ;:n}•.;.:.:}:{:.;:.}:::{:{:::;:;:;i{:r{.;n;{xiy::x{x{i•:n.::::xnyx:.yr.-v.}:;.}u}v::.}:.i•}:Qx•}r•}}}:{{3}::x::x.} �A.•.•,I UtP1u11=t '{; ': Q�• }. C�OP .5�::?} ; }{••::::}I x 12.0 = }moi,•:x:.�ay.:v:::.vsw:::.v}:::x:xwxenvrxxwm xr.W {vnv4:nv ix '�: vxN:ihh�-}:'w�?:, O GAS EQUIPMENT+100,000 BTU DUCTWORK)M x 15.00 = Iry '4 y� �' V{,:110111101111011 #6011 I.P.I.k G:i:ttA::Q:1'1't;; k., - 2 X 1.00 = 2 . 0 0 ... ::�nv ....nvvtuvn�;�'}n• v . BOILER/REFRIG 1-100M BTU x 12.00 = h } a,}b fi}:;•}'4`%r,.}✓i•.}•}v:::`;y::-'.•5t?:::�4::?li = :��IL #:�f ��l :�.���>':Jt�)..:.::� :�.}:,,::.{.:n,,.}�.•h:.}n:,•{::n..::r::::::fi:•;:<,::.:.;.:. x 20.00 .-.. ..-.•J.Jv.-,--i,v::r-v4vw.v:x::.�:.v:.............nx.....,. ,... ::::::vrvv::.v:.vv:nw::nyw.:v vv::.uuw::::::ww:rw:.-. ---.........r. :.::.: BOILER/REFRIG 501-1,000M BTU x 25.00 = ::B-:.:•J v.4'-•:. r:?::•v::r'(r%S?}i=:}:isi:::t.::::ii:ri:}i{.r?+::iiiy:' ..../:t��(. {:I �1�# <�r��3��'I'{:+?�;�.��SC).M;I�'�'.�:n.::ay.:>.:4.:;,.:::::::::::�:.,.::?..�:::x x 35.00 = .--. - ..4vvx :::::::::.v:.v::::nv.xhvv nu•!£�n.r v v ..n..v.v...v.nv..nv...n........r-.-r......-.r..0-:}:n..w.: BOILER/REFRIG +1,750M BTU x 60.00 = v:.}:myry{:{;y::ny.:•;;.ti.:{rv:.;i:.v.}vvygw:ax:xf::pvyrr.•.v::.;;.x•:{.}x::.}}vvn•::;;;y{::i:}v:}�$}i$i{:ti_ {i{:vr HFA' `?I% P '� ,tR tioV 3'{t�- :TbNS $ j x 12.00 = i,•::::.,:::. ..n.{...,,.. ,n,..,,...n..rla,..,.}.,wnw,..,�.a�?xn•:�.rr.,n,.x.... r. HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = '. ;in:rr:.}}}v;}h;•.:.�u-{+�}} •fi,vyyvwr{vm Mw•!•:�Y.--!}v,T y},-ryvyv}vrrJ,uvx•}•:•???:'.-�fi:,y ? t '` 1 �'xj[. k ':5: i..R:PI.) ' 1 :-:3f:'1<t C1t,�.<1 :k-,w?'ir x 25.00 = .,..n..nvn...,...,..,w:n:,,,•}:n,v.,:k,•x:n:.w..n,fi�.•..rn,.�,:.,,.�w}n,.n,.n,�:n,,.:::n,•n,vw:n,•:.,.:.w::n,{i,}. {;.}::, HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 = x{{.xx::nr:r:{rrnv ;xr{v{:{rx�x f:.}{y:{:{{y i.:;::{:rx{??rS+:{{?{:r<<�.}:;x.}X.:ry T PUMP AtR C :)Tit „R+5G T N$,}�i? a x 60.00 = VENTILATING FANS x 10.00 = 100QxnvCSrM } • s +<iy % asalt x 10. = TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = ' ...:I?aI`#aani ,}-r.�.:•�:-,�rarexr :-'.:,:r.:n. x 10.00 = ... ...:.. ::. CLOTHES DRYER x 10.00 = IIIa•wxx : « ` % wr X 10.00 = GAS LOG x 10.00 = yy::::: y}x:{;}• �rnfuwn w: vry�nvvw}v.}vv{r{: im CE Atim `j) ctignR I S. til _ _ R ,;s:: x10.00 = :lwi•:{v?:::{vri-.;w:rnvu4rku,:vu:vv..vnuiiv�vwt,wnm,uu„vntwwvu{w::...:::.v.v..n n.......n ?vvv UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = /titi/b�. P E ySayr�� ;i':•:?}:y.;•?}i n�.tt��M•'': :�'�•:��-..y•vv ri':��'? �riJ: ..:/a::-- = .T�C�<.�'�.,�,A....�,ayv�?(.. .�.:CR: ;t .::::;�'� �'<`�?:>:;>�:...-....::. x100.00 USED APPLIANCE<400,000 BTU x 50.00 = w>gofAt1G>r~ opooC'o:v:x:::s::::x::eamm..::.::.i x100.00= AIR HANDLER<10,000 CFM x 12.00 = e �}('', F� ►may(. ,O A ?{j�.ni�i!il:+ii%^iY•}:}}:?::v?}:C??}:p'-??}?}y}}:?}:i}}}fiF.•:?%-?}y. rr!:,1.�::�.!:N:�II�:!��S�:T::���V��•�:X:��C.'}:.• ^'?}.?{•}:•?�•}:?i?•.:4'4::{:{:::k•.?Y.?w::in}:r•}?::vry;?::n:- = ..................:..............-..--....-:::�:::::.:::}:?• .�..N.,t;>:?.::<: �:'y�:.}:•:;•?;':.??,:-:;>'::;'->:::'i:>::;;::::y:?;}:.:-.:?::?:::::>�:::;:;-: x 15.00 SUBTOTAL $ 9 nn PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE =$ 35 . (L.) SIGNATURE Spokane County Division of Buildings Ufoc•' 1411' Drn.n-1.., ., %A/A nnetn /CAA\ Ace. n,-sr-