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1992, 10-12 Permit App: 92008732 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM Sj-C In#ormration Worksheet �� JOB STREET ADDRESS:, /70,2 LAU✓AJ /eh ? CITY/STATE/ZIP:5 mt ('� , 99o2i( PARCEL NUMBER: l s l Sa OWNER: f / 11. '4 Sac os t�� PHONE NUMBER: 9p7e2 MAILING ADDRESS: Iv FO2 1,1c2001- 4)/J /Q6 & vie_ '✓a• c72_,•274 (Street) (City/State) (Zip) - CONTRACTOR: LICENSE NUMBER: PHONE NUMBER: MAILING ADDRESS: (Street) (City/State) r (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = KQO.:::.S:::Q.:::V:::._..u'�..�ITIZO:::::::::.:;::::.}::}:.:}::.:e.,.:::.}:.}:}:.}:.}.:?-:;:;::};:m::::.}:.}}:.}:.; x 25.00 GAS WATER HEATER x 10.00 = ~``:1 ::`MEN1?:?:}::: }.:...._::.::: .;.}:I.: <.:_.. :.,:.:..::.:::?::.:_ <»>>>> = 1.030'}}}}}}:. } .00100 ;' NMk,O11 ,.r:}:}:>N J x 12.00 GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = •■ .n:f:t•n}:.}:\:•}:'.}::?r:•}'•}'•}:.}:;..•{.nx}::•:::•F?•?:ii.}:•:}:•ii:::}}:?4:•}:v:?v}: :I.i:i.. 1.}... :r?h?¢::h}}}}.t..:ti.}:i??:}:?:????.i?¢y?-:.?:v}:.i ii:::i::4}:}:.}ii::g _ :��4Ss#�..I�..I�L�'.':� ';C�11...1„ ...f......:::.::.:........:...........::.. �.. x 1.00 BOILER/REFRIG 1-100M BTU,.,. ............... n. x 12.00 = � �� F }II�1=�1:C?' 1:��''.-'..'-�.s.�I��.11![$8' >�:::::.�}::.•::::.::.:::::::::...:..:.......:.....::. x 20.00 \v::::::::: : :::v:r.. ::.'v:.vA:: ......:...,v:v....... .,:r..,v r.....:........,� BOILER/REFRIG 501-1,000M BTU x 25.00 = 000I 1 F1=R1C 1 QO --t;75QM a "U:>:<;:::f: ;.>::<r::>;;k::»:::>::»<: x 35.00 = BOILER/REFRIG +1,750M BTU x 60.00 >PUMP>�':A11 :: ::: D.:: <: - :::: -. ::::;; . ::.: <.>:::::<:::>::»::>:<:>i = 1 '�� " ' :��...1'1'1�I�l�I�.O:.�.T��S.::.::,.::.:::::..::.�:r:. x 12.00 ....: ...............::........:.... ,.... .v .}x\•n:L::.w.:,•.vnv.:.,w::.•:•:.:•}:•ix.•fi:.:w::.•n,•.W nv::.::vv:::}}v:n:.v. HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = HEAT Ptd 1'giatt .N,v 1 atift1INt1<.:..OWI:;.}},};}E x 25.00 HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 r- fitxtPUMP......:::.t> ..1 .1 1 ..........C)....tl•:fi....�0.,..: .... < r> >`io x 60.00 VENTILATING FANS::::.: ...:.................................................r:..:......:....... x 10.00 = .e.YARQRAT1Mg1tg �':".}SO.::.:::};.::.,.:}}?;r::E.:::.::.�:._:::.:::::.:::::::.:E x 10.00 = TYPE I HOOD(PER 12' OR 12' PTN. OF HOOD) x 50.00 = ......................,....:...:....:..:.:::.:........ : .:.......1....... .......:....::::::.:....... :..r`::._.}}.::::::::::::::::::::::::::::._::::}.r:-::::..t?.:.}';::?::.}:.<:.:}:.::: x 10.00 CLOTHES DRYER x 10.00 = I ....dal*<' smoiii<ioiam ` ggmim =<>«gnm x .,..�..�.�::.�::. ......... ......... ......... > ......... ......... 10.00 _ GAS LOG x 10.00 = 4 1 G LLAN C7!US(NIC _COVERED ELSEW. I< ......... x 10.00 UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = U L NSTEDGAS APPLIANCE>4QGsOOO B 'tl :::>:<:::::»si ......... x100.00 USED APPLIANCE<400,000 BTU x 50.00 = USED mpogNGg 400s+000.B' U.........:«<::>:<:>;::»>:::::::} »>::>:::::>::::;::<:>::::: x100.00- AIR HANDLER<10,000 CFM x 12.00 = AIR HANG:.;'.:::.>Hx.:;':O:.:.1)7:0:<`�� •;;"> 111NO »>> >> >'BERE > < = ......... .... :::::::L�t�.�'ftp,�Q.�.;��M:.::.}:.;::.;;:.;;:.;;::.;:.>:.;:.;:?.;::.;;}>:.;}::.::.;:,;:.;:.;:.;;::.:;;;?.:.;;:.;;:.; x 15.00 - SUBTOTAL $ PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE =$ SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675