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1992, 08-31 Permit App: 92007035 Dryer
MECHANICAL PERMIT APPLICATION FORM t '"-' Information/ / Worksheet JOB STREET ADDRESS: 1 S OCA 1% /- 4 if • _ Cl CITY/STATE/ZIP: Pr t... ' • .4 - PA-CEL NUMBER: " \ OWNER: gv`U,C�2 1 Me (Q.... • �e_S .PHONE NU BER: 6-01.- q 2-2_,-- 5 6. Vo MA ILING ADDRESS: 15'00q e. V'a-(k.e.. vr(a� o a.A.Ne \ ,6-. C( q Z L C.Q �, (Street) C ._ J City/State) (Zip) CONTRACTOR: �- O v...2 Ow v\-2.V' LICENSE NUMBER: / / PHONE NUMBER: 9,1_,_�-s� Q O / MAILING ADDRESS: I 5 00 ` �c Vf-j/�L./{,, (,-/,�9 ,.ci�� (Ai 4-- ? 17-1 CQ (Street) (City/Stat� (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = WOODSTOVEIINSERT . ' >> `:::>: :" ... x 25.00 = GAS WATER HEATER x 10.00 = GAS EQUIPMENT<.j00,000:STU(INCLUDES :><> . ': x 12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = G;.;;;;::;.;;:.;;;;;;;.;:q.p.;; OUT(_E.::::::.:. ::.::.:.::.::. :. ::.::.;;:.;:.:.:.:.:.;:.;:.;:.:; :.::.; :.;:.:.;: ;; .;:< .;:.;:.:::< : :. = o x 1.00 \ . BOILER/REFRIG 1-100M BTU x 12.00 = SOILER/REPRIG 101-SOQM BTU '_::::::`` ` ` ':::: : x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = BOILER/REFRIG 1 F0001 1,750M STE1`:' ";;:; x 35.00 = BOILER/REFRIG +1,750M BTU x 60.00 = HEAT PUMP&AIR CONDITIONER 0-3 TONS x 12.00 = HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 = HEATPUMP&AIR CONDITIONER 15 3b TONS x 25.00 = HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 = H EAT PUMP&AIR CONDITION ER+50 TONS ;; ; x 60.00 = VENTILATING FANS x 10.00 = EVAPORATIVE COOLERS >:.: >'::: :; ' >;:.. x 10.00 = TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = TYPE.II,H:...,. -.D.....: :`;' ">:'':':'::':`` >::"::<::::::<:::::::>:::;>:>:::.`.. ::...__ x = C74 ;.; 10.00 CLOTHES DRYER I x10.00 = to. o o RANGI= ::::::::>i:.:;<':'., . ,<:.;:<:::<; :, x10.00 = GAS LOG x 10.00 = MISCELLANEOUS(NOT COVETED ELSEWHERE `.:` ` x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ULINSTED GAS APPLIANCE>400,000 BTU .... . , x100.00= USED APPLIANCE<400,000 BTU x 50.00 = USED APPLIANCE>4p0,0Q0 BTU '.:'',;.. x100.00= AIR HANDLER<10,000 CFM x 12.00 = AIR HANDLER>1;0 t06.:CFM ' :: :.::.:::. x 15.00 = SUBTOTAL $ w 00 PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE =$ (,-6') SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675