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1993, 03-15 Permit App: 93001474 Log Stove CA 1�1 t1 MECHANICAL PERMIT APPLICATION FORM 3� Information Worksheet JOB STREET ADDRESS: I 2 / o CITY/STATE/ZIP: PARCEL NUMBER: OWNER: PHONE NUMBER: MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: LICENSE NUMBER: PHONE NUMBER: MAILING ADDRESS: (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = iWa.A.MIWNWOMMENOMMINEMEMEN x 25.00 = GAS WATER HEATER x 10.00 = 0.:0r; tr<:,,i;<:..::.>.....:,..,::..::, :k::_: v<,::} tit' x 12.00 = J!1:0 ro:4}}}: ?t�>.tN 3; J ROO > :<; :<.};f:}.AM GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = •P..I ..1!C:> 11 ��.',�-?1:!:�[� ti f$4�. {}..: . ;}4}{ :.h<}:::<m ., x 1.00 ... ::.,{vn,vvr\,w:r Er., ...... ,,...ii}:J.:}:..?..?,,.n ,� •'titr ...vtt:.t.��:>.rv...:ln RG4}.,nr{, BOILER/REFRIG 1-100M BTU x 12.00 = E `':. . :>$:}. . ".Ntk::.::<:.r n.; :.> x 20.00 = tuft #:�{�3 ( ��>��>% 'ls�..:. . .,:.{•i,4.:.•..}x..}:....:}.:.:_..�::.Y� r. BOILER/REFRIG 501-1,000M BTU x 25.00 = {::.F4if::;'}'•i:::;}'.:x.:}if'.,.y,:n...?x:r..ir:yl..nr...r..•f'4Y;m?r:;•;.::r-'�-}''}'}rr:}:: �:9:f;�Y.,`:#';::�: 11 ) I .:010 • : �- ' :Q antai <F:>:> = 't,.:::>: x 35.00 = ....... ,•:}::1:.,,,,•:}x..:E•x:x.,.,.x}.,,:..�1..«•::.,,:1:.,,•n,,.•::•:.,•:.,,,,�.,�:r:::r.�. .v:..........,,:?•}z..::., BOILER/REFRIG +1,750M BTU x 60.00 = .}:.�:it;•.,•:•:is:..+:;:::4•.:?..:;y:.::.::r::;:4•.r:.w:{;f:;+v.•:.:•i::: .:{: r ; . •'•4;: €HE4''=�? 1 INV P 1 f ;): 1:OR' ' ; L M(, `..... '}i�r.•; x 12.00 = ..........:..,lv\\..,,..Wixx.wkrv,-..v.,4.v 4:x.4f x.4r.Gvn44 .. .............. HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = € 1''>M C�: )I : t 1 1 T( PE 7` C I " x 25.00 = .,vAvv:.vw44:.w4v,xxvn,v:4x4.\::.vv$.,,xxhv.xxx?r.4.vi:.,vnvwvA\„v:n,,,,vxr. .vt n ... HEAT PUMP&AIR CONDITIONER_30-50 TONS x 35.00 = ::HEA�J�»� :4•.x?:?{.rr•:�xyf{v:{.$?4�:.•:•}•`:.: ::{•y�:x;�,.,,:::`4��.:ytrk4i+r�xr::.'��+'x."•.-/��t `�~':�•i:+,CJS.<`h:1`s`n x 60.00 = �X�F�:? : .: ::)'% i1::1 }�!!:`.�sr�yy�] ..w7. ti!Rx .c. °.}..: .4 ........ .. ...4mw::.v..:n:..vx:::.:n::xn.:..nw.v.r.x:�s}xx..•: ..rn.w.v::N 4.,d,•.,r:.v44F:.KV�.. VENTILATING FANS x 10.00 = :::M.v.•x4:.v,vr.}wtr{}w.v:v}•:r.:�.�:4' :},} x{�:SY.v':}v�4'v,.};frxrr}�µf: .. ,}4 { ry,}�,,:r..•.. f ? f: x10.00 = TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = ;s:''.}t;::•i,.•#;:,:<::•rY•ry;};x. ,gr'.'ESdi}•kfi:3%;c`.- '•;`•::'•.::;94f.: :t. :... ;.:•?aS:Yi.'$:i.{:•}).`+:{:Zr::x:,:{✓..}x•.},�.,tk t,Cf},v}:.,P:{:;-::.<:�•"•r•:4'•x}}: •/f..3,:?;r. x 10.00 = :.:{,vvif:llr:•}i::•ii>.4.::n'•.t•}n:.v.4:?rryih{.{i:i.,v:' }.v:�:•,v,.:. tf4�i•%?•:'� CLOTHES DRYER x 10.00 = r.,:• .}:+f.it{''f%?Ifv%:r}i?'':i':fy:ii:::$i: ?:v::'•'M'{:':iir. :.}y%rr�?'r?•}:^•fti4 r•}v}:•}:?:?{.;{?.'f..};{{{�:�,x{. __ ' fii:S::Sts 'f•}:q.f x.ci•.};•f:• C':',;C•: { ',9?•} '}ow -; `•ti`r..''` �►ry/�VW+f;4:{. .:,•ff.•}: ::`::r?s:.yy.+.:pf,ycx::.'• t?jG'2::.' r...:}.}.:',. ?t?`:'-,'•'}•::.:::ori }..v.4fi° %�.t x 10.00 = i .S#.?1V,.+Ffnv'- .v..vnQ•�i.•rv...:.\•nii40:if•:v.i'•'f.:vP�:•:+�}f'iiik:iP' .d[iv.•t:4::,'t•:•.v..:.i}:4:,vv,�v} •}h�i:+xn4N4:::: GAS LOU x 10.00 = nv}.wn +f:..:.1}v,lx.•.;n:x.;{::x.:x{::::�sM1• �4;f�. I.N(5R N S`j)I 1 >PQ l . < C S k' mo.-.•* x10.00 = .. ,vf.,,,vv:n4:w::::x\,L,L:,vx{,4::.,,,,,,�f.,:,•.,{vw.w.?vvvwnv.4.w,,,v.,v.A,v.•xvvn4.v.Wfn4rr. UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = OL1` ..:: 0:.5: `..h.a:,}.��..�i,�,:w..t.1.:..: ��yy0�y�{Mr:k,S.:: :h ::.::; x100.00= USED APPLIANCE<400,000 BTU x 50.00 = <:}•:;:,.v.r'i: x100.00= AIR HANDLER<10,000 CFM x 12.00 = : > . ;::u. , 4,.4{.v..x..{.r:...::. x 15.00 >'At�: :AN�I�:f �t�.....�t���Q:�l> N44:}>�.h:�;.�}:{t.:}}..:;.>< >:<;;;;;:<:>:<: �::»: = SUBTOTAL $ PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE = 5114v SIGNATURE Spokane County Division of Buildings West 1%11 Rrnarlwav AVPnIIP SnnkanP_ WA 999RR (5n9) 45R-3875