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1992, 01-06 Permit App: 92000060 Furnace, PIping
MECHANICAL PERMIT APPLICATION FORM c // "/� Information�� Weiksheet JOB STREET ADDRESS: 5 • 703 (/I/,44 As cm) CITY/STATE/ZIP: `sd / GO4, 902/2 PARCEL NUMBER: OWNER: /c d 7"e,4.coc ant PHONE NUMBER: MAILING ADDRESS: (Street - (City/State) �/f (Zip) CONTRACTOR: /9//6 /%62 S • ✓ �C' /7`-7e LICENSE NUMBER: /i6)--r7 `J Y�c • 714-147 /(7)°""9-47 j� • ���7HONE NUMBER: `2`?�� MAILING ADDRESS: Y1(3/ �/ yG7 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = :v:}vvv:xr:• :vv.}y9::YF rn}}{?:i)r�:r{__. •;fV:-03" rir1�y-"'iGir?4}±'Y::-:•ji__ _� ''i'%':S+f?._Li?irYf}�: SJJCJ)`" A{?lir}i.:�i'::.:v '{:....: 3# ..- it"lt_I. 'W?:,::.:::-;::;:::::.::- :.r}:. = }:,O. ;>::<::<::: x 25.00 = GAS WATER HEATER x 10.00 = :::AS.EQU_P II t , _ 1 AES::::_:>;::>;::;:<::;<:>-:>':;:::::: x 12.00 = �.0-v GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = :_:��M.KS�F?�����:1��1!r•�, : 4 K?,wr`?j�2Y..:___'3}y{r`-?i±::-}i'•::':':�. x 1.00 = I aL BOILER/REFRIG 1-100M BT1J x 12.00 = .:.. 1 #if #n0;;T;�:0 -v--4BWi_ifs_r<>:: ...................."---�-----...: x 20.00 - BOILER/REFRIG 501-1,000M BTU x 25.00 = •±xNxr,w•::rn:xxxxaw:nvr £'t:v.}vrn.f M'v::xr:x�-{_tiJjii}::is:::.`•:::.v-:}•iv:ti'i'.\:f^'-C; _S.Ej17# { I .#MM' } "� 1 C8IVAI::_>%:;:;:::::<O `<:::.:>::: x 35.00 = BOILER/REFRIG+1,750M BTU x 60.00 = ? 1 .El4,;1011 1 x, 01:41: ::>;=:: ::<:::>:::>:: x 12.00 = HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = il:---r..v..ir< ... rre•: .- F Ik t <' ra:>' :'< < x 25.00 = ,.HEAT PUMP '&AIR CONDITIONER 30-50 TONS _ x 35.00 = i�-:T- l-4:��1/.-�.l•� W ^fH:rr4' t r{i{.:i-•i4:gi::.: - C_ C _ ? I t�3 A� ..<<?<?::±_::i-:-.<:. :f_:>':>: 0.00 VENTILATING FANSx 10.00 = _ irisn ..._:}::..?-..a;•::;}>;::,;:}xk>ra,,..•>-.,-x.:::::::::::.-:.�::::. ��::�a:rri;::::;: " :: ::z<:-=-=>:"r>n•:<._..._.......... x 10.00 TYPE I HOOD(PER 12'OR 12' PTN.OF HOOD) x 50.00 w.y}r:_:.:.:::y^}::v:}ii{:Jvn,??:n:av:..?.vi:±•ii-}?}:i:.:3}:. _ _ :�}::ai�ii�i}}}_; = il.'+!!.i4!+-. .1 }i:}i^.:..,..:-y:.}:v-`-?:-.v::..?}r.::,vv::::::::rv:}:?vr:[±,:::::::n{•:...:iv :..::nv::.:::-:.,�. = ,:--'4,�.,-r.::-::rx::::�::•::._::-.;r.-:}:t±::•;:-;:-::-;;}:-;x.;;-}:-;:-;:::-;:-:_}:o}x3nx/.•:}}:�x-;:±;.;:???.;:t:;::-;:-:-;':;::-}}:oc-;::::;.:;. X 10.00 CLOTHES DRYER x 10.00 = -- - -- - - - -- --- nif:P: - :- - - - ..:•::..........................?-}:s•:::h::::y::r; }::::?:.:iiia'':,"¢:iiiti} :.}.: X 10.00 GASLOG::.............:.....................:..,........:::...::...............:.:...::......................._..:...... x 10.00 = 1SS . tEOUS(NOTCOVEAEI)ELSEWHERE : x 10.00 = UNLISTED GAS APPUANCE<400,000 BTU x 50.00 = ULINST GAS APPUANCE>I00,000 BTU'>::<`< <''::=> »' x100.00= USED APPLIANCE<400,000 BTU x 50.00 = USED APP ANCE ,000 BTU ;'-;. >:> : ;<_ x100.00= AIR HANDLER<10,000 CFM x 12.00 = AIR,HIANDI ER>1.0,000 CFM x 15.00 = SUBTOTAL $ 3 .cfv PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FE IS . 5.00 EQUALS:TOTAL PERMIT FEE DUE =$ 3 8,dC) SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509)456-3675