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1992, 11-09 Permit App: 92009935 Piping MECHANICAL PERMIT APPLICATION FORM l a "..c\`)V5-9 Information rksheet JOB STREET ADDRESS: 15 0 0 !a 3 ck(0o\�c� CITY/STAT ZIP: �� IiLQ ? c 3 7 PARCEL NUMBER: OWNER: Nle nh L1 - i fr' t _ iy.z.ie6 PHONE NUMBER: c14-'i - 6 / 7 MAILING ADDRESS: /5006".6". E 13 nAAciLis2i y O 3 7 (Street) (City/State) (Zip) CONTRACTOR: S e&ws...- LICENSE NUMBER: PHONE NUMBER: MAILING ADDRESS: isamu. (Street) (City/State) (Zip) ' _MECHANICAL WORKSHEET/FEE SCHEDULE c7 3 5,000 01 NUMBER X EACH DESCRIPTION �'x' OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = i.:.;::;000$10.0.0EIE'':;:;:>::>>:::::<:>:«: ....... .. ....... ........ nn........ x 25.00 GAS WATER HEATER x 10.00 = GAS QU PMENT'100100 ►B'TU(INGLUl3(<.5;:<:::>:<:::<:::>::>:<:::>>;::>::» x 12.00 GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = GS x .. ..... ..P..P..NG>�-� �I~?U....�, �:::�::::::<�:�:.;>;;:.;:::<.;:.:::::...:.:.:.::...:.:...:::.�.:;::.:;.::::<:::::::.;:.; 1.00 BOILER/REFRIG 1-100M BTU x 12.00 = BOILE::'.RE«::i>._,1 = �::t�.::::::: ::::.�:��:G:<� �>:�5 .:::;:::'.�`i�:.:.::.;;;:.::.;::::;:.;::.;:.;:.:.::.:::::..:.::.>:.:;:;:.;;:.:;;;:.;:.;:;:;.; x 20.00 BOILER/REFRIG 501-1,000M BTU x 25.00 = 'B��>ILS :.: ;:.:,;,::.:;:,;.:...;,.:::.:.:. = :.;;;;�.;;;;:>::;;;::1���;;:.:G.�,:000 :.::�x:.::m4r�.:.;;;;;:<. .;»<:.:;<:-: x 35.00 BOILER/REFRIG +1,750M BTU x 60.00 = MOOPOMPlikkKOMPTIONORMTQWESEIN......... x 12.00 HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 = i;::.: !,': ; INO;>&::.;:ER. 7! t IT: (<IE11040'(1000:::.>:: ::>:«:>::111 x 25.00 HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 = H::::.;;;: PUMP AIB 000( f'C10N011+40 7000::»>::>:;:1111>:: ::1 x 60.00 VENTILATING FANS x 10.00 = 'EVAES::..:R>.:>::.:::::::E C::..,.,<.>.:_>::::.::ISI » < > <>< > '>« < «<<< = .:�;;;:.::;: Q1�A'I"(1fE�t��!L�RS.........::>::;::;::;;::;::>::>:::>:: ::»:::;:»::>:: ......... ......... x 10.00 TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = • ":PE<:> _>. '»". :. >< » >«<> >• = '?t�.:::.;;:;.;:.;;:.;:.;:.;:.;�.�;.;:.::.;:<.;:.::::;:.:;.;;:.:;.;:.;:.;:.;::.;:.;:; x 10.00 .:::::::..............:...:....:...:........................ CLOTHES DRYER x 10.00 = : ►N: :><><<>g> <<< < <<< > '.<»'>< < ><< `> < <> < <``>< < = >::.:.�;::;::GE ::.::;:.::.:::: x 10.00 GAS LOG x 10.00 = MISCELLANEOUS(NO' COVERED ELSEWHERE ....... x 10.00 UNLISTED GAS APPLIANCE<400,000 BTU _ x 50.00 = ii"U .--.STED GAS APPLIANCE>400,000 BTU :;,::;;::;;::;;::; x100.00= USED APPLIANCE<400,000 BTU x 50.00 = x100.00= AIR HANDLER<10,000 CFM x 12.00 = x 15.00 = SUBTOTAL $ PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE = $ SIGNATURE j Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675