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1991, 10-28 Permit App: 91007252 Insert, Piping MECHANICAL PERMIT APPLICATION FORM _ InformationnWollysheet JOB STREET ADDRESS: lc 0 ca - �j CITY/STATE/ZIP: S Q/iI 9/.1/. / 2,0206.PARCEL NUMBER: OWNER: /Da/e / ' f�9 ei/ PHONE NUMBER: !G� �4' --5-7 3 MAILING ADDRES : �yJ (Street) (City/State) (Zip) CONTRACTOR: /17/1 i/VOc /iij �fl LICENSE NUMBER: ft /DC�/9/� 4'©9'4'f)1 s J PHONE UMBER: 3:5- 3 . 1?/-0MAILING ADDRESS: ` ^CD/ -CD.)- E /47J 7 S4,126).- % 9. 9''F'...-C.) . ' (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE . NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = ::.:........:......................::.. .::_:E.R`' BRO < » = >_ < < = �t±4C�i� t!�a�:;;::.:;>:.;:.:......._..:.;:.;:._.......,>:.:....._....;::::: .>::.. : x 25.00 GAS WATER HEATER x 10.00 = GAS EQUIPM sziOgi?t -$TU(INCLUDES•. x 12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = ;;.,.: :_IPI->..:::_ ::._,.._;.:.<,->` < ,,. <> >> > »'> > <<'>> <<>>>»<>><<< > = 1AS ...1C{ AU'I' . - ::::: . .... x 1.00 BOILER/REFRIG 1-100M BTU x 12.00 = B 1: -::RIEF.-.;G_:.: -50tA.:>�t < > '- ><=< x 20.00 =t3. . . ::::,i*•*> .. . : BOILER/REFRIG 501-1,000M BTU x 25.00 = .>EO;.:_'"gt"-A:,<:-"OgG: ;-::0--: <1_:; -<:>:.> _.;.;.; .>_;; p'>p p'' < < ;> >' = C3]LI=# /IFt�(10 ,TSdIu!BTU. >;> x 35.00 BOILER/REFRIG +1,750M BTU x 60.00 = ;H �AT UM� > AIR CON.; ...>,_...:.EFtIt::_3 TON;.< >> > > > - = E .- '........ :::�:::.. DSD{-----R a 3 TONS........ ... ; x 12.00 HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = HEA'` ife gi 1 1 D ITIONER15-30 TONS :g�>; ' x 25.00 = HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 = H:EA .tomeil:':`AI t ` N MITI :NER.+:50:.TON`... ... :::: : :;:;. = - .....::;>:.;:_:�' >;;::�; :>:::;:>:-:; �;;:;;;;;:.;:.;;�:.;:-;;;:::;::.;:.:;:;;:;;:;Q.:;;S;::;:<,:.;:.;;.;:.;.;;..;:.;: x 60.00 VENTILATING FANS x 10.00 = :'EVA ..>:, ..;;:>:..:._::.:.:C::OLER '=>< >> = « gigni > > > iiinig' =::::...�;�p14' �' :;`� L��S.;:.::.::..:_::;:.;:::::._:.;:;;:;:-::::._:;:::.;:-;:.;;:.;:.;:.;:.:.:.::.;:::::;::.;:.::. x 10.00 TYPE I HOOD(PER 12' OR 12' PTN. OF HOOD) x 50.00 = E IH >'> >» � > >>>' > > > '< p> > > >::>::>> >` > >'> >> > >><><'>> = '1...,.,;:>:;,,....;: t3>;;„,:::;::.::-.;::,:::::::„::::.::.;;:.;:.;;;;:.;;;:-;:.;;:.;;:;;:-:-:;_:.;;;;;:;:;.:.:.>:.;;:-:::.;:.;:.;:.:;:.;:,::.;;;;:;;:.: x 10.00 CLOTHES DRYER x 10.00 = RANGE .... .> <{<>< < < <<> > >«« =>> ><< > `< << >> _ ><` > > >'> > > < < x 10. 0 = GAS LOG x 10.00 = M.:::::: : ;�SCSfC!001l±1 'PG4:.1=>iEDuSEWHEfi ::» x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ULINST AS APPt 1t E X00 030 BTU> > :;::'. >::>; -:: x100.00= USED APPLIANCE<400,000 BTU x 50.00 = USED APP1.!ANCS 0,000BTU _ ' :>::::>::>..... x100.00= AIR HANDLER<10,000 CFM x 12.00 = Alii HANDLER>10,000:CFNI x 15.00 = SUBTOTAL $ PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMU PER` T FEE IS$35.00 EQUALS:TOTAL PERMIT FEE DUE =$ SIGNATURE ....A 1A-D - Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675