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1992, 10-29 Permit App: 92009490 Insert, Piping c9Aa-9(AID MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: / ) 5 /0 tri ,,,,e__) —1 lOB CITY/STATE/ZIP: t,1L 2 (A 9 9037 PARCEL NUMBER: OWNER: �. ---OA. ? Q c A/fp ) PHONE NUMBER: 927-Y 7/7 MAILING ADDRESS: (Street) (City/State) PP) CONTRACTOR: EA- )C.c" C 42c jJ CEI,I}Fi2 LICENSE NUMBER: r4(CA&C.,173 b Lt PHONE NUMBER: (-5060 9..2(0-e91/ MAILING ADDRESS: e • (131 0 .5-(3012A,_9ue, _,poK,g/Jp )A.)A 992 oGo _ (Street) ( ,i ;State) (ZP) .... MECHANICAL WORKSHEET/FEE SCHEDULE - A t4UM1L' R X EACH DESCRIPTION OF UNITS. UNIT AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = • WOOD S :: --..<.:::: ..:.. .:::.:..::. x 25.00 = GAS WATER HEATER .,....... '--�----:.�:::�???.�,:..:.........•---»:.r:�_::>.:� _ x 10.00 = ,_,.:.{:� .........;(105-4101:00170-R. `- w 1 x 12.00 GAS EQUIPMENT-4-100,M BTU DUCTWORK) x 15.00 t rnG31wNG RAU7L :" + ttI EMvige � x 1.00 _ : . t -72,:,, ,,,-, .DJ- ,it ,-,4::,,,,A6;.., BOILER/REFRIG 1-100M BTU -_ - . .-- , - - liti ,..... x12.0F r. �x ` �� : �}� � �� x 20.00 .,-,,,,,t., :- BOILER/REFRIG 501-1,000M BTU; :-.1:-',i,','4::-'4.'-'4''-'.:. .:-:4. . s _ a+� ii! ^3',r` - �. .X25.00 . ...‘-',...e4-:. .--:,-'47::::57:.: 1-0:a E4 'I - . X11 E ?R vim:? x 35A0 a �` BOILER/REFRIG+1,750M BTU r ... <..• L E P JTI 'AIR 0:11. ; QNO. r N$ ` •0 _ x 60 00 -.,k ,., ...-�.x,._: :, � x 12. 0 - _ j HEAT RUMP&AIR CONDITIONER 3-15 TONS - - x2000 X25.00 -,..,;;j..-.!: ,,,,..,-;',1••:=....'i:-.A.4'.. yam. 1 HEAT PUMP&AIR CONDITIONER 30-50 TONS- - - x 35.00`= , , 4 <PU• • I5 IR CONDtON1 +5 :,5gl ? x x 60.00 -.: .a VENTILATING FANS A-1...;.-"...'::'.::•! .:-:!'.2:.:i.-;-;---:: -a X 10.00 — � 7 �t K A � l Y.fO: YF ':cif��3^' r'h.n(�pq, �F�':i-• = :,r l T E07#R0�� ? : •: TME �xit} v? Yv t� 4 d7 „r:..aw...r...,::w a: ,ao-:..•: :.....: .....-r.:.dSv.�.�a :.�::y�� s r, 4 rt J> .�.. - x 10.Vo �. '`� TYPE I HOOD(PER 12' OR 12' PTN.OF HOOD) : • . x 50.00 ; :.:f,,,.�;.,:_:::w,:..:..:;z-n�;:xr?Y::;-:?�:?<:<v:;�:?>�;:-:v_;;:.;:?N?.,�„�...+??x:;�;,;.::n:,,Y,. ??.;max:,,, — _ � ...:....?:>:.:.:....,..,.-,:-.,.:,:.,.k::��-: .:_ .,,:......-- -- ,: x 10.00 = _ CLOTHES DRYER xV ' .:.::. . .:.::: ` .J x10.00 _ ���, .......... ,.:;:� ...:.:....... :. % 1 .....:::<:::., .,....... x10.00 = n �-er _ -� - �� x 10.00 _ MISCELLANEOUS(NOT CO 'ERED EC:SEWHERE <'<:` x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU -- x 50.00 = = ...: ULINSTED GAS APPUANCE>400,000 BTU >: ' '=<:< '>>:` x100.00— USED APPLIANCE<400,000 BTU -- x5000 USED:APPLIANCE . ........n...a.�.:..::..::.:..,.: :::.,-:::.:::.;:vY:;:?.;:. :::::.:...:<:;:�=:>::. x100.00— AIR HANDLER<10,000 CFM x 12.00 = I ;: HAND >.,,.::::. R:.; R'*. 0,000 CFM .. ..:..,... ..:., x 15.00 = 4 SUBTOTAL $ 1.,PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE _$ 347 b� R SIGNATURE t Spokane County Division of Buildings