1992, 12-02 Permit App: 92010552 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM 93- IL✓5. -
Information Wc�ksheet
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JOB STREET ADDRESS: U� F E - -1, i
CITY/STATE/ZIP: 'PC` .1:-) 1�'}1,- PARCEL NUMBER:
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OWNER: �" 1 r\-1-?Y ETA t-_Kt PHONE NUMBER:
MAILING ADDRESS:
�` (Street) , (City/State) (Zip)
CONTRACTOR: R l P /IA77ki £ a 6 LICENSE NUMBER: aeR/-fie II 4 /04, T3LLJ
PHONE NUMBER: TO T- /4-/QS
MAILING ADDRESS: E• 0013 �i2,1/ JS £f4&se 99 ao7
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT =AMOUNT
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 =
-ry�Y.•. F..::::::::::::::.�:::-:::::.�:::::::......-..:....:.:::
... LTi:V}7!.�'_��7E�i:1:.:::.::-:?:}::::...t::.:�:::::::}:-::->}::•>r:>:-;:.}:.}5::;:::;;:::;:.::.:ii:;<::i:::<:::;}.2::�: =
.:.......::.......:::::::::.:::::::::�: .:::: :::::. ::::::::::�: ::: :: : .:;. ;;:.}:;}}:::;.;;;:.: x 25.00
GAS WATER HEATER
:;.,?,:;}•:?;:::.�:}.,.?.,::.>•.;:>.:.,..;.,:.:.;.i;::•>:}:;:?::}:.;.:.}?;:::,.:::;.:;::<>;::.}.;>?:;.:::?:::?:::::i:::>::;>:::;::>.:>:<:»»::>::>::>: x 10.00 = i D. OC'
GAS QUiPMI NT IQO;t 1 .1iti <>`'<<><»; x 12.00 = I - ( ‘
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
<G S PIPING`{:::: ..,?,..4 >:.: .:•?:}<:>:: ,
:4� 7 ? .x::.f:sa::a� }.r.... x 1.00 =
.::::::::...
BOILER/REFRIG 1-100M BTU x 12.00 =
-. 1 igMgI�-.••?.r{0-ig ARNV<::»::;::}::<:;:;.<::>;;>:.;:.;};:?.};:.;;;:;-:,}:-<};;:-};;:.;:.: x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
:I.i,1*R/.AI*I=# 1.{�..`I:�AQI3. .. M.8 =
..:r.....4rv...:--�...:rr-.:r..r:.v.�...:�.:::�v:�::.,.::�:....::.v:: r:v :.:,:4:4:;�.::�:?4}:.};::.::::>}};:.>;}::.:?-}:?.}};:.;:.: x 35.00
BOILER/REFRIG +1,750M BTU x 60.00 =
HEAT PIIt P O Wl CONDITt.alti OIMEI ::;::}:;:iii.:.; x 12.00 = :,a CY-
HEAT PUMP&AIR CONDITIONER 3-15 TONS 1 x 20.00 =
HF ►TrPtl<MP$c AIR CCU (7 N0 I: ,, Tt )SIS . r:..,....... x 25.00 =
HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 =
SEAT PUMP&. -.. 1.CONpiTJONE R:+54<TQ-:S€€><< <'i'N x 60.00 =
VENTILATING FANS
x 10.00 =
0.NAPO:Na E COOLERS •••.....------ x 10.00 =
r:::.- ...:fn..v. .n....r. .....:... ........:.::i:{i4::ih.'{:ni• .4.:...rF'?:::'v'}j'.''v':i
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
hXgvHOO } r : 4Yif ? yi . ^ :
iiEi+
x 10.00 =
CLOTHES DRYER
x 10.00 =
"" •
..r}xxn0.:vkw.-.:w-v.:}•Y•i}-::: xv:::::::. -:.:?•..v:}nA4}:?i-ii}::iii:}ri4}Yn'•ii}:i.?•:4th•:{v ::.:ii:v}:v4iiii:ii i :i: X10.00
GAS LOG ila2�pL A. Ce l x 10.00 =
:MtSC . I*ous t d ED ELS HERE x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
::.: .;}::;d'}:?:{i?v}: ::••;r:::;:::.;::iv:ry;:i::iiiiiii::?ii iiF iiiii ii:
�;UI TNSTED 4S APPLIA gI , r?4tt Tl�.--.> > :<> < xl 00.00=
USED APPLIANCE<400,000 BTU x 50.00 =
SEq.APPUANOE>4-igi l>:<:»:.;:;::<:::>;>::::»>::»><::::: ::» ::M>::»:::<->::>. x100.00 =
AIR HANDLER<10,000 CFM x 12.00 =
A R HANDLER 0440 CFM........:::::>:;:::::: >: ....:<:>>::;<::::>::::::»:: ::: x 15.00 =
SUBTOTAL $ aNg
PLUS: PROCESSING FEE +$ 25.00 •
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE _ $ LplCO
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 Qat- Sg