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1993, 05-10 Permit App: 93003332 Mechanical Fixtures � i s Op Q\3- 33-2_ MECHANICAL PERMIT APPLICATION FORM 5/-7(4? Information Worksheet (0-1C1 _-1C1 3 JOB STREET ADDRESS: _ . O 047 /f✓i'�6v r0IV DC7 CITY/STATE/ZIP: 5,e,&-7-P KA_ PARCEL NUMBER: /• OWNER: 2 /, (-1/'�/JQ/-i PHONE NUMBER: '92_6.- 9 ,/. -- MAILING ADDRESS: SGI,)-yE' JJ (Street) (City/State) (Zip) CONTRACTOR: ,PR / o 7a t/ CA , in/27 56 • LICENSE NUMBER/Z/4' 1i O C 5/0n., �i PHONE NUMBER: MAILING ADDRESS: / �� I ����°� S n�cv2� `�� '79 2/ 2_ (Street) . / (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = _ n:. :.w'` v :•. • :'::� ::::>:iiK:::: ::;::.:•f s:<<: x 25.00 = GAS WATER HEATER x 10.00 = � ' � x 12.00 /Z GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = .y.::..•4..:w;• f rr{rmnxv Y:x:nx,:K,}h':. }4:4}• frn y.•{::.;.r.. '.;yr•''?^' .i;?`c:.c::::,v:}•}•Y ti;::;•r': }y(K�A€'`PfPIN.��.'. 1z ; > bs ; ,y,� .::<<::-:4: 1 x 1.00 = I "_ %{v}?:}:d {4Mwirai:.4 it :Jn4Fn•:,Ur. :i4.tv':.4:iii4i:n:A:v:iMM0.\"'I': BOILER/REFRIG 1-100M BTU x 12.00 = ?^ < +'' fir."•.}••: fy fi.:{•..::•.,.- 4M.I d Mu }t, f0 4::::4}w}n.}�.::s,;, x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = < o g liwo ?( :rt•� : ' ;''"'x>:. x 35.00 }:.N... ,a ?: ,K.•.a..a4 ,.•rw.a,,. :s'2 .:{-. .?•3x. BOILER/REFRIG+1,750M BTU x 60.00 = .}::x::r..A•:.Ynv:4' v+f-. M'r. \:n.•n. ..,.„„*„..,..:i..:„..........:.::*: 4 ;f- "O T .Sff x 12.00 = HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = •M'+•Y•Y`u. : Y• r{yp• t.}y} ' €'P y.'; ::,. ,� i •O� - ;" w} . x 25.00 = HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 = r.::�..:rr:{::ryy4•:{:�{�:)(:.r::::..� -b.. •i. f.{:: .?:�:: 4:{{.�: ..:;;4 x 60.00 rITEA%4r-:: 'NOW0 A 4Trrir�vWr. Yi ..1„P.:Mre' { ,:K4:.: .A M::4f.•'� VENTILATING FANS x 10.00 = EVAPPR " .• "`f . '}` } s x 10.00 = TYPE I HOOD_ (PER 12' OR 12' PTN. OF HOOD) x 50.00 = "y (? lC'H:17 �y • p ,':< ' ' y�f',Y;•i:,f.S;•' :rye::: x 10.00 = ::'•- -:,a :?-.,..,w.3:it`:.�.t{-r.Gsdt Yk aw.:;'G:..•`u:.uv'k�}r"� CLOTHES DRYER x 10.00 = .:.M1 j,+Y i Y.. 5 L '•3 �'f :"~`::.,•.;;ti{;1 �>+'•'y{{.�{^ .4}44,:::}: (� .•.{::. .y. :;•,F,, ;� :; - :, -S:•:{�' x 10.00 = �•.'� '' .'•} .. '{•3 Y�•`:7,:{,:�}::{kayvx45•;�v s.5..wft7wk ...x..'..-"4."'' .'f GAS LOG x 10.00 = �4• ?+•cam{zy.<W: 4+�w•:. , K{t 4"Cl . :: •� IT x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = :xvyr.wi:f.'•.:.,,,:.vy'.,•row yyv:{+• 9 4y. u}v...-•:.':}:.v W:'.C..}:?:}h :tr.�•�..i,,�:ry,M"C)v}.;.x.,O °:• QIT.�'.• ' ' trtl ' ( `' r<`�?``: .?`»:}= x100.00= : 4}!?!.M7•itAD i.�T1?,•%• c�c Ffi. „iv.v:,..?V£y}i• .. :.:...::::::.,:•::::+:::::•::::4:::::.:c•7.:.:,•. USED APPLIANCE<400,000 BTU x 50.00 = .4::::.::.::..:.z;.}y...:.::L:.},>Y.,.:::{:.,.:.Y.x4:{.r..k.::E:,,�0_E.:::rrr., �:,, •::.........::: .0 :•:{«•}:4•{- fUSaRgi li iee04 ...«.If :,...„,s.,„,„:::,„:,.........,..,......,„C:C : . 4 ::.-{.4.;.>.:{;},}}. x100.00 .. ..... u:•Xvei:::.,w:.•i" rx...v.x.:..... ... ......n.:.fn.r r. AIR HANDLER<10,000 CFM x 12.00 = •.,•.�}x.Ypv.�,:c:n+wr•:yw.?y:;•,y•:J':`•"}}•.y;;..k:i:::: :r; y:v;;:;'}}£{;-0:2.4>. .4 e t `f>t :O?:(?: A I..... ..4:'..}:::: <:::::::;: ,s:>:;:<:>;>::< :<: f :•.}:.>::: x 15.00 Witt: !�N;-:::}m:n?4:v{• .v.v�•.,v:.:•.•.•lv:kn�:nv.•]t�.v}.Av4n•„:„%.„:nv v.:.:R fv.4:::.::::..„:...•...mvr....% SUBTOTAL $ / PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS:TOTAL PERMIT >,o _ FEE DUE _$ c7( SIGNATURE 2 //(/ • - // S•okane County Division of Buildings