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1993, 01-19 Permit App: 93000241 Water Heater, Piping MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: r` 7///3- 'I '` /�'-CL 7r2/7? CITY/STATE/ZIP: J (N) (09-1`-' e / LU 4 PARCEL NUMBER: OWNER: Pc yd t. u- . A\t E,L) '1' PHONE NUMBER: MAILING ADDRESS: (Street) _ (City/State) (Zip) CONTRACTOR: 6 l.0 LSI to LICENSE NUMBER: PHONE NUMBER: 926 _ 9'6- MAILING ADDRESS: 3ht-4t. ( Si- Ab"" tJ --_.- ----.--_-__ (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE ,. ,. NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT t; • ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = 'i, ::�. :.»v,.,:y •...:,{v kY . .:v:,. ,ti x25.00 = !` ::::::.�:.xv:n„•n.::.v,•:::.W:.•:acv:.vA:.v:: ftgt j•':`.•x�:,5•�'.••.'•til:+:ri:l..:�iC.vh.v.2 k'nv�'.v .{aT.,v .... GAS WATER HEATER / x 10.00 = /D*`'v :.:ti:;:.:.:;s•., ,fi:....,..r.,.::Ml;{.•.{:.�..•y,,,:vaf^'::. ...$:: ,,;: .r f �. vr,.. ..?_ � « f« X12.00 _ Ah,,,^ , :%vrri:: W': Y..vvi.Oc• 3 '•:::r'741 nvv,:., :.T:1$ i }i, GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = f ' O PI CIt T' V44 .Z r ..>. `- / X 1.00 '_ f 41, • BOILER/REFRIG 1-100M BTU x 12.00 = ; ,, .�,.•,.•::::..::::.,,,•:::::::•:.... +n•?�+a 4,,.x •,7, yrn+•n. �. ,.'$}.•:•{,.•.' `. t RI{ . l * `;{ .r,431 ,` �$.:.�' ,. x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = a..v:x::::•„<.,.•:::•r,::,:.wr.,wrw:,,:�:..�:,y::{r<• :v?u.,•:::::::.mC:{:.::� .f k n•: „:,/.t [tg �1y{ fjt °1 ' bVjt i K � .'. x 35.00 = ..•,�•.o3SL�.��"':.,nh{•:.;e,�' ',t : :x��..,w ';vR,o:,�.,::'Y- s 33.E:A.a. 2� •.gip BOILER/REFRIG +1,750M BTU x 60.00 = 1t t ' C40:1.: rx12.00 _ Q HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = _0 . p'. 0,g"" O x25.00 = -',1 0 HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 = t.$ r '`" ' i .4.t.R : r .,,:�s't s . x 60.00 = v.,,.5 � :.. rzsd {�, 7 fi x :.. .,rte VENTILATING FANS x 10.00 = t fi` 4 ,.;:.:::.;7•,yr k•.;•: Sao- fig• S '� �a ""�" , `'t �aa+ '� l* •'' { si X 10.00 '_ �y, ; TYPE I HOOD (PER 12' OR 12' PTN.OF HOOD) x 50.00 = ,,,A= !P' f< AF S l x10-00 _ ,- r 1U�, . w wtt•:� No CLOTHES DRYER. x10.00 = ' 6. :4 •:4 x:. % x10.00 = • ! ;K ,'4 GAS LOG x 10.00 = 610G T SIII ::$;y„yE11 ..7 S .:: ' , '' .•': x 10.00 UNLISTED GAS APPLIANCE<400,000 BTU x50.00 = g5e$w.:01004 11..11*I cVV ,•. ��*Q . Y � USED APPLIANCE<400,000 BTU x 50.00`= yONttiA Ggxfu OIitg, Flliuis x100.00= AIR HANDLER <10,000 CFM x 12.00 = 7 i AN ii lit lug...,~•:•h,''»>. iatiti:s:,>h •� �.l x 15.00 SUBTOTAL $ --- PLUS: PROCESSING FEE' $ 25.0 . r: NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT . - ( 6'0.- k' FEE DUE =S. SIGNATURE dam ' Z ,, 1G.'- �,cn Spokane County Division of Buildings West 1303 Broadway Avenue Spokane. WA 99260 (509) 456-3675