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1991, 12-05 Permit App: 91008432 Wood Stove . MECHANICAL PERMIT APPLICATION FORM Information Worksheet 7i - U 6(3 2-' JOB STREET ADDRESS: 12 92--.7/ / 011 0 c OU dv 5256(61 CITY/STATE/ZIP:, aJA- 9"9-2/4, PARCEL NUMBER: OWNER: PHONE NUMBER: MAILING ADD SS: (Street) (City/State) (Zip) CONTRACTOR: ClLICENSE NUMBER: +o C.- 57 a©�`, PHONE NUMBER: . 2'---7-38.8 MAILING ADDRESS: (.t). ;1 ' CCM- 99-20i • (Street) ity/State (Zip) ' MECHANICAL WORKSHEET/FEE SCHEDULE I NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = W...O .QSTOVPINSE T va : } . ua'.vx}kuxfixt x . .Jpl • GAS WATER HEATER x 10.00 = AAgi:iggPIRM:PATAP0001433411$APPMERIMIN x 12.00 - GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = :P!8§.:!4?:,:_IPING EA 4LITL x 1.00 = BOILE /REFRIG 1-100M BTU x 12.00 = :.i.:.:..::..:.::.:�:.!:: .:.}.? ;.. .}:.i�: ry ::::::.�:::.r?:?4}i:?•iii.:i.}}:tii:}:•}?i}::.�::.y::: g0tggMg.P'#a t 01.. ,:<.? �::::>;:>>g:U4 ; , x 20.00 Y^.. •a.:..•::,e....:..::...?.•�<;O r.,awso�i�•���.�.r`M.s...,j ... :.t�,,K. BOILER/REFRIG 501-1,000M BTU - x25.00 = � : . . : x : { wi }ibiwtiKl9hx35.00 = BOILER/REFRIG+1,750M BTU x 60.00 = . - #iEA 'FUME .AtR .00:01lONER Q$TONS><>> x ' < `_> x 12.00 ;. . HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 =_ HEAT PUMP&AIR CONDITIONER- 30 TONS t::>`;;`<< x 25.00 = HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 = ' H.EA'T PU P&AI CO DITt:4NE +50 TONS><h>ry<•<><>11 x 60.00 .:.:...�.v.::.vv.:.v:::r:}::::::::::.:::::�.::::::::n�.::rr.•:.Svn:v}.v:::.v,�•r:A�svv:a.vv:.v:.v}:nvvv}::Y.v.v}rv:,vf.:::•::v:. VENTILATING FANS x 10.00 EVAPORATIVE COOLERS......... ::>::_<:: :> ::>: ......... ......: x 10.00 TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = TYP >:;:.>;�:1:N; :.: D;; .;;:?;.;;:;>:.;;>;:.:.;;:;:?;.:_};;;;;;:�;}:; .;:_:;:.:;;:.;;»:.;:.:.;:.;:. .;;;>;;;;.;;:. ; x 10.00 = CLOTHES DRYER x 10.00 RANGE ' x,10.00 = GAS LOG x 10.00 = MISCELLANEOUS(NOT COVERED ELSEWHERE; x 10.00 = UNLISTED GAS APPLIANCE<400.000 BTU x 50.00 = " ULINSTED GAS APPLIANCE>400,000 BTU x100.00= USED APPLIANCE<400,000 BTU x 50.00 = •USED APPLIANCE>40O 000 BTU. . . ; x100.00= AIR HANDLER<10,000 CFM x 12.00 = AIR;HANDLER>1;0,000,CFM, .; . .. ; x 15.00 = SUBTOTAL $ ...:25^.. PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE =$ 5"0 . CJ SIGNATUR -ta:-,-4) Akdc-aed Spokane County Division of Buildings West 1303 Broadway Avenue Spokane. WA 99260 (509) 456-3675