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1992, 08-19 Permit App: 92006599 Gas Log, Piping 0-__ MECHAir(ICAL>. PERMIT APPLICATION FORM6 v ( ) 4 .information Worksheet f ./ I yg -7 _, JOB STREET ADDRESS: 5 • a 5 I,A3' 1Ai► I \ou a, / CITY/STATE/ZIP: �cY- A r� , u_y q ei -106, PARCEL NUMBER: -` 5 2 • 6'7 [r ( OWNER: 12-(>(\_ok._I . I v U_S1-o PHONE NUMBER: "..2 q -3-Iy.3 MAILING ADDRESS: 3rwv-,.ems (Street) (City/State) (Zip) CONTRACTOR: EFS )Cc", C 4i2c c)J CINtF,2 LICENSE NUMBER: r44ICD &C.I-73 bt c PHONE NUMBER: (50q) g.2(0-?9/ / MAILING ADDRESS: E • (13 I I] .5p 2A91,C e. S ooK-Ah12. LJ A 99 2 O!a (Street) (City/State) (Zip) . __ MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT , ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = (�� ..fit;;:v':i-' :�:ii'-4:::?:i}i'::::: :::..::::::..:-.........-....-..-..:?::-r.; .....00...51'1;3 1l�PISER:}<=>::_=<:;_::::: - -- - -- -- = GAS WATER HEATER x 10.00 = =-tea S� � `.... 1 �� ., ,.,.;,?:._:::,:_,:,::.;->-?_., ;.,> ...,,.<��«==<>=> _: ��= . - QU-.P. Elis 00,00 MPOPtig x 12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 PLOAlilliONVICOlitettititinglittliiiiil a x 1.0 - ' . BOILER/REFRIG 1-100M BTU ----- _ - - x 12.00 {{ X 20.00 �:..s:.u7ar.w,oc�.a,c.,,.:,,...,_a ..w :.-..:.,�,r.,,.::..:tw�� .w ,a«„�.v x+r�.maaw„afi��: - -i BOILER/REFRIG 501-1 000M BTU:. .:L.'---,••:-.1.:'4.-,';:.--=,:::;::-,-:--;:•4•;-,: x 2 x 500 , .. , BOILER/REFRIG+1,750M BTU t_-_. �:. -:: /�_ �y x6000 . ` 5 M 'r'AIR D ati � 'N- ? .,vv. Y yr ��� �. .: CCI .-1�0. SONS - . .;_ x 12.00 --:-..:.?:',-, 2:::---,.--7,--.-:,-. HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 -' 1 Mat HEAT PUMP AIR GOND NER 1 x ..:<.::.....;:.:......; -•--:..,:,.��� ...:v.�� .13(115-�.�: :: x 25.00_ •: . ::.. 2sv.mt,Lvw»,.v.x...m.<-n:,xvrx:.... '. - -' :-.:•..,-•_-L..,_ (-;,/.---- -}.�'. -,- .',. . HEAT PUMP&AIR CONDITIONER 30-50 TONS tw x 35.00 • SEAT PUMP ".A .ggi DITlI'gNEp+ 0y IT x 60.00 -. :,wn f-.-f hnv x...mrv..vrwwmvr::v ......vx v :n.n.xh ._xxrv..nvn...v....x......:r]vwiw{<4:�:viuJii:i. . , VENTILATING FANS :- x 10.00 x�: .rk?.,..::;:.?::.Y,, :N::N. .•<.?::,-;:::�:<;:-w:<:.;:-;??:;:-.;::m s _. : :.:;:r srs-.:,as>x>-t ... _ - &1tAPORAT1V#CQOLERS• :::?:::.:.:. ::.. x 10.00 = TYPE I HOOD(PER 12' OR 12' PTN.OF HOOD) --- x 50.00 .. .. -- TYPE 1I:H a =::>::>: ?<:>:::- >::>::- :::::>;>-.:::.. ..........:...... . . .::.:.:.:?..?:.:. 00 - CLOTHES DRYER _ __ x 10.00 = :..:;-: :": ::> x 10.00 = GAS LOG.:... x 10.00 = aw MISCELLANEOUS(NOT COVERED ELSEWHERI_..< . :'= x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ..:.....:: LIN T,::E ,::.GAS:APPUANCE�400,000 BTU ...... .. ...: x100.00= USED APPLIANCE<400,000 BTU x 50.00 = USED.APPLIANCE>4 .....:.-:...._.;; ::;:::;:. : ::::::: :::�::.;:.:<;:> nn ::.::;. - x100.00- AIR HANDLER<10,000 CFM x 12.00 = HAND _,. LE R:.:.::_:: .:_. __ 1.0 oocf:ii- Ektiiiisigjiiig,TH..$i-,:urg:iiiii!ing.li.::!.i.:,:,:**];;k: x 15.00 = c14 SUBTOTAL $ QA- 00 t.•PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT °9FEE DUE _$ 6/7 SIGNATURE Spokane County Division of Budin :