Loading...
1992, 09-04 Permit App: 92007072 Wood Stove u\c35"3 ` n 1\ 1 �. ,: _ 7o7 a c����� MECHANICAL PERMIT -.:"PLICATION FORM - l ��o' Information Worksheet JOB STREET Ar.-..E.'..:-:ESS: // Q7o 7- f-" � / �-Q�'�� CITY/STATE/ZIP: ,i'0.10..&_-.1..-L___.� �-t/, - P CEL MBER: OWNER: 0 . ..,7,`..�i C , ; i PHONE NUMBER: q - a --� MAILING ADDRES . I ' 70 / r O(ye,,� F-4 (Street) L (City/State) (Zip) CONTRACTOR: )U) G p ec iJ xi f EY2. LICENSE NUMBER: F-44I GO&C I-73 bid( - PHONE NUMBER: (5Dg) qd Co-89/) MAILING ADDRESS: C • 6)31 b .3p 51,ke SpOK.Ame- -1A,t9 992O(o (Street) (City/State) (Zip) -_. .._ - • MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH - DESCRIPTION : ;, OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) - x 10.00 = WOOD OVEfNSE ..:.-.. :-:::. .:....::. . .. x 25.00 i� .w.vmxx.vn„NniW..mm-:.xwwv:nmmvr:.iwvtt Yr::J •?.Wuv n'C:yyw-i<t'i'"- j.: {.xwGji� , > GAS WATER HEATER' . . : x 10.00 - ' � ,fin _ �'. >G.ASS ECiIMP iilEN' ki000 00�#T NC_• 30ES _- . x 12.00,- - -,= -L - x. GAS EQUIPMENT+100,000 BTU DUCTWORK) r- - - x 15.00 -f-'---, :-;;;.1.:. t �..�.w...,.M,:. j� n..�,.. ;w.'}s..:w,. -,w.. ..:.._,w..,:}}v. � Ft x +��X•• 4.+ GA. PIPING T ....€�: .,...... {- +J hccf t }i! p a { x...1.00::: .-� , t-• z7f �.t!�.- S=ro.`� $f"' L Mw:-1"►www?lw.v •.vM•..' �iQGGcir{GOurO.�TAi.Yi0004:. '4Mr .. BOILER/REFRIG.1-100M BTU - -- ' 4 r.Y -tX 12.00 =. ..k r�` ." = ` . MEDI . ..,:.:sw2 : ,4 ,•��.'�3Y ta'i. ,1 ..:a•fw .A `x 20.00 Si 4t-w. 7}r ria q.. , -y �.it. BOILER/REFRIG 501-1,000M B : .. .-' 1 -' t �, '� r,...... � s TU, `r�." tic» r-s ,X25.00 - -�.s��'.:r��' s�'+"S-\ + s a.c...�,.ri• EFfi1G 117400: "'`' M_.. f fp `3"'4�'c-y`a. K' S. ra . 3...$)a. - +rL-�t�t - W17 .( .., - 35'.00.;:t= AC M .. � +� �!N x 35.V V '.'RL4iI,�Yi tVt•.y .i/^"bT� '/.'\ BOILER/REFRIG+1,750M BTU rr - ," I!. - ,4'`3 77 - r:-,,,:".''- . *x 60.007=4: T F 4; y '^ 'rale' p• M" :A1(3COND.....ONE 1 NSx ,ia=s<yfiwww . . - -?:12.0r.-4. - 4.-.4,7-4=44-.:.MI,� st':`- �,. ,� . , : : «�... � .;yri, �:a,..,,.. .ar„�j,_ ..- s'�. �+q- i� �.�•:� a ., [it HEATPUMP&AIRCONDITION5TONS .�.,.rx 'x 20.00 ;y. s..O-` iti4a' ,.� rCO b?�T0 • ;i .+{� - i. s x 25.00 t . l: ,O , + x t " ,1.�;. Vic;::-; x'HEATPUMP&"A1R CONDITIONER30-50 TONS � �° •F x 35:00 =r .._ - r-- :+ice c . . . '.le '.tirdial D�-: . Ems. < :.�5 ' > _ . '"I x 60.00:",=",-4:' .. i..� �: zz-itt' -: , VENTILATING FANS ;:^ t .'.,.. :t.',.., ..:.�) .. _ . ... x 10.00 ,. - YAP:'3: 8' GOO.ERS.". „ {., ..}}:�.�,,� 4Y .}e h -i'.4-7"•....,-.,,-- x 10.00 1 ..--"-,. ..": -.1::,x,'.;•:-;.:;,:__ y .. 4�� � .nnr r G.Ovv:er:Q .401�.:d3t.�.�'OGS-•i�rw.w.�fi��W� :�+.I1t5 '� --• :-, TYPE I HOOD(PER 12' OR 12' PTN.OF HOOD)4. . x 50.00 - -:-%-%,.:---, ,--7:7-:,-:: s z :,:;_:. , !:: .{w ..ac :::!Y �xx?sg ?M>�:; :::ar. arcxox o:,.N�^ ;., .ry, ,}v* ` c:. 7s.. ....v f}c:v...;;v:n:v�.. n' ...... ,,.``.:i:::::::. v::,:};r ti:.` - x :10-06:: -.;.:-.� --,-----'----,-:,' - ',1 - xxmmvxvw::n: V�.C•.LCN Jw.H vviA�( }v` VAvY.0 ` - rt A CLOTHES DRYER ..' .- :: " . `:. . r.4._. ..t}�., +l+�e,(:A f-^:`xy� :<'nc•-:-.C'�` v{::h_a;:�'^ Y'< o �,t C" J S W.;v•.:r r!n J-iet.Y*:�?-fii~ }kJCQ• ,{y-'.<{::L'-.�} X 1 .. - > fi ..::::+ ,:}::}.»:=4:.F:.,4 ^: ::^:_}v:{::-:!-..ti: 0.00„ .�. �.1.....•...R{�:hk:.Zoi.}.}c;;;uii::a`7.':c':a;... �.:%i1a::�i:w.....:':Rx5L9F{ {-x...::x::t:Gidaca::S.`::. - GAS LOG t` x 10.00 = :MISCELLANEOUS OT COVEREDELSEWHERE x 10.00 = .......... ' UNUSTED GAS APPLIANCE<400,000 BTU x 50.00 = ULINSTFD GAS APPU NCEa40C,003 FTTJ x100.00= USED APPLIANCE<400,000 BTU x 50.00 = :!.;p:::m.:•: {.i:-1^i}:•}_^:•}iii::^}is{r!!{.;{}:v,.;.;r!!!..�.:'.{:i::-}i: USED APPLIANCE}400,000 BT{ - x100.00= AIR HANDLER<10,000 CFM x 12.00 = AIRHANDLER>10,000 CFM .......... r x 15.00 = ''I SUBTOTAL $ - PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT o� FEE DUE =$ SIGNATURE Spokane