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1993, 03-23 Permit App: 93001741 Range, Dryer )c.c4\-\ 0* )-1-T MECHANICAL PERMIT APPLICATION FORM --d ) Information Worksheet s.Z JOB STREET ADDRESS: // gore) // /...`/ `� �} CITY/STATE/ZIP: • /�/1, PARCEL NUMBER: '1,521 1 1 , I h 7 OWNER: .�v-7,4 "Z PHONE NUMBER: MAILING ADDRESS: ( - (Street) (City/State) (Zip) CONTRACTOR:,--22-1-0/4/601--,5LICENSE NUMBER: ��'AiES`"eds/ rn v PHONE NUMBER: �9,8 7 MAILING ADDRESS: Q, \ (Street) (City/State) (Zip) \'1 • 1� L\ \ MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = :,1 :::.:;.Y• ;: : ..}:} :}«' {.},.:.}:::::v:: r>:.:;:>:;:k,:<}:.:: .::_{;'}:::<'::<.:>::: x 25.00 = GAS WATER HEATER x 10.00 = GASEatatxvxnmIII MnkN^ L x 12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = ••y,:n:v.•ryy:::::.yw::::.:6'':rr�i4'.?vr"4'+'i•'' nits+�.�:"+�.v�:if?{ii:if¢�'i,:2:?:}C}}}i: 4�<I;:'I#:'::tt!tC` �QT1 : .r.�'�,....:.�",��: .�:{},.:..<.,4...,}fes.:.,..�}<}}:...<rf.,._. �7 x 1.00 :n{.:,v:rw..vw::�n+ n.. .,::�v .iiLX,:h\v.t..vKv{S�iv,4•..�hvti.v:ti{vvtw.v,vti:u}%?J.M•.v:::. BOILER/REFRIG 1-100M BTU x 12.00 = }.x,:' :'::%:x:>' .r:>; h` ?n: >>•::>><;':}<>:.#:z = gag �� � ���" �(� .:f-:-:.{r..::}::.��r.r:••::,.:h:,•:•:.;•:•}::::.:.,•:::::, x 2 .00 :.:Y::.,,:,v:::Y:•:::..:..:s:::wYY::::::r.::::v •::h•,.�::.w:::,w.vh,v<}:.,•}...:}:::,•:::::<:::�:.,,�::h BOILER/REFRIG 501-1,000M BTU x 25.00 = COMMENKYii/{:v,:x..{:.:,+N..i:�•'-'..,%?.:{..r..:?urn;::+• xx:::{nidi:}tiiY{:�t�x:i':r:{%>.i::ti{:Y''ril :ii::?: M" s<> ' ,{<>::4;r t:<N:v:<:: x 35.00 = BOILER/REFRIG +1,750M BTU x 60.00 = :::p::::r.•vr.}v:�r`:.}•.w{{m•.v::f•;nwn}•.v::x::vvv}•{xvvv.vrr{�};r:.y::{.v inYxv.;�:ti1{r{::i,::i::i{t-v::tJ3;?:t: >FI #'< MO,,+ • .B # '[` ;.O ., O ,IG ` ., -" x 12.00 = HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = MMERMENNEONIMMITEKAPOIRM x 25.00 HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 = •{fr{ffi?f •.t{v x:f�xA v,:.Y::nv fjLCii xf•r:?::::::x:....{}.:i{•:{::{:r•::•�{::%{i- v$:-:Ir,•v,•• _ • ••N �h...}}.{if-i'\,Y::'In}CY:{: x 60.00 = :::::._::::.:�:::.:•::::::.,•:.:h v:.:,,•»:rrrv:r,.•r r:::.r..,,..}...:,.,:.,.:..r.,..,,,..a.,,r.....�F.:r..:.:r.:.r:..f....r..,rr.::......:..•.. VENTILATING FANS x 10.00 = ,,,�'.,,:.,•,>.::.}„�..::.,,4.:.:;.:•t}v.Y•r.}:;�• ;u• '{�{{: ::::.v::.,.v.v:::::::.w .r,.:r•. EONNO � 1 VINIES•>rISIOr{,.::: x 10.00 = .......:•:::::........::.. ;...aao-3.,,-:::•:r:rr,::::::.,::f•:,•.:, a• c,:: }. b•).:r,. xe.:.$)r.:?•}:: TYPE I HOOD(PER 12' OR 12' PTN. OF HOOD) x 50.00 = vka1xDm \ MNN x 10.00 = CLOTHES DRYER / x 10.00 = /0 IMS} % » x = # Is : Qx % w / x 10.00 = /D GAS LOG x 10.00 = ,.:,}•.::,;w{...,v,,:::{.}'r{:,•r::rr,..{.,::r.�,;r:r:{ :.:w., �. �;si.;{_z. MtSGELCi )?IEC U$&: `5 X01'Il (:vw'::..'r,: �....'.:a;:;,: x 10.00 = ..,�-.z,,....:.,,v,.v::.,:,,.:.{,:,...�.w:.,,,,,rrw.,.:�.. .,,,,.w.r...wh,:..�,, ,f.:.,.- UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = t` [(: .:M;M::�::::}:r. :'<:: ::`: x100.00= x;41......!M���4�:i?A���4''14:f� � ;•e!;"i6til�Y V� : �};?51...vvr.}:r:...:,�....:.:....... �::::v::.�:..:•.::.,•::::::.::,•::•:..,v v.•::::::2w.�:::.w:..:::::::::::::::•::.�:..,...:::::...:.:.:v r.r:rv.,......:..,•::::,..:::r:::. USED APPLIANCE<400,000 BTU x 50.00 = {r:m}•n::F..r{.},:Ls{..:::::::xx{1:fiir}:-.'" YY !ai:S-�` .• :} >: :1�> ,,.. <.:.}{::jS::: �wwwr:::::: x100.00= AIR HANDLER<10,000 CFM x 12.00 = AlniiitiAMORMIONWIMINEMEINIMENIN x 15.00 = SUBTOTAL $ PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE =$ 57 c� SIGNATU ¢-� U _. . `� Spokane County Division of Buildings Wast 1 nnn Rrnariwav Avon!to Snnkana WA QQ9R(1 (6(1Q1 ARR_1R7R