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1992, 11-19 Permit App: 92010246 Gas Log, Piping MECHANICAL PERMIT APPLICATION FORM Information Worksheet / y�� JOB STREET ADDRESS: ~. hb's' (D2!' "' CITY/STATE/ZIP: SPof c& v► e Lk.)(A . PARCEL NUMBER: OWNER: LG 2 R y MC I C N h y PHONE NUMBER: 5 - C-6 MAILING ADDRESS: E. ? (S /.S S/3okc vle F4Z/z n (Street) (City/State) (Zip) CONTRACTOR: 134"C fkoccho, c„ta QN? 4.1. LICENSE NUMBER: l3Ct/Ef}lioPSM3 PHONE NUMBER: S?S-7 4V-5'O MAILING ADDRESS: e• `(1 $ 7P SP o(e-A -e LA..) • �42/z (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = •:•Yi,SY. :a5%..:fi v."•u k;E•:: u.:ry:,`{�;::a.::;ci.p.}••<ya i:::} = �Wt7 OV0::ggAV } < :•::. ; ; :;:;;::w><. > u:> ><;:;;:>;:: x 25.00 - . . . r GAS WATER HEATER x 10.00 = MN 60. f Y� tet r }^ : : { ?• x 1 2.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = {:..,.: },.:�+}:..w, Y °", :#`: < x 1.00 = ( . 00 BOILER/REFRIG 1-100M BTU x 12.00 = I # f S �' : .': . ,„?,,encs , x 20.00 = ixa{•..:::,•::::r.,•.r:r..:r.,..,,.:n„na„u,.::f`/{.w&..udz'saarw,ow,�.asa}..r;.. a,. BOILER/REFRIG 501-1,000M BTU x 25.00 = et,g� 0 �s r :r r{ytrr.«...vtiya;� y,•ti}• �{:::r.k•{Z: �?':�: x 35.00 _ BOILER/REFRIG +1,750M BTU x 60.00 = .t:r ::� w y:..a� .r .r. �.y ..}v:..y{�:rx sf><r<'<; x 12.00 = ......... v:f+x:}r:.w::f::::xv.•.C..:..•+tx rxA. xA�.•.Y.m HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = v}v}vvf:•.y.}+:•.•v.+ r�}vj�} M yw+„xv v�.v-.y:+}, �}v - ,`, ftMME1s MMB' ; 1a {{ t : � x 25.00 = HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 = p .•{.yr{r�n r,:-.•:K{x � :F r{: t{l\{.}% IX{r'i.• .'s#: 1 -t :: -T`O y�j . `1 x60.00 = fi:.:wy:��-.,•.r:�•:.:r,,..a}f{•,c:k3..oc.-.i.}Yo-a;. .:a.irY:•.•}:.;:.w,.,,,..c..:bva}. :ic:•f ''�:,cY,�;cxr' :•<?,f: VENTILATING FANS x 10.00 = }ya y:.y.:w},y�rt , - e; .fi < x 10.00 = TYPE I HOOD(PER 12' OR 12' PTN. OF HOOD) x 50.00 = :.,y....�:.y{:r:o}„y..}y.:i`�'•rr:S.. f K v' :y `a+.•.T•..u :,?:ci :.may :`,,.}�",iz:.;}sy}x{'.,r',i.,:;;:: '(''':l' . 1 OIRI >d . .. .:.°r;. <...,,.•`,','.;.,2111 r a` } .:{ ti x 10.00 = CLOTHES DRYER x 10.00 = �:..:.};•";- ,cra:+:,'.:;.�v:r�.{:{.:�! 'r;,`2;'.ti{'. .:{•r.!?vii:<::n'.'•'}'t-=�Yv':�-`:%:n:x�':r�7£{.i::a:�::`::}:;t:: {{.y}}}: ;�::.vf:::.{r'r r :;,..+.''co-Y.r•::•.#'%:+.vr:::. {'r,.o:':^:w:::S}{::: ::_ :c:•?.'f}::::::::.:».rSI s}}} x 10.00 -.���? _ ..4i:':i>.':f:Y}>l:•k'. r'!:'•:L•}:i>r,:Qr: i} �r.. .n+.<>"..........:>�:�fi•'.'Y.-..;9..n:..:.:5.{t::a};c�it7.'.•::J:v....«.............;�i:5:: ............:..,........+:........... GAS LOG ( x 10.00 = (o . o o :{:..r:::{.}.::.::r:{<..:>:.:},.::. :.:{.;c:.;.r�..:+.::,;..f,v..::..:r..:::.:.}.r:.,..+:,�:H.r;::.y::.:::{:.:,y:::.,,.:;.,.::;��>r:.�r<�>:: MC 0BI~.# 4t�1: C S< �� ')"'I ( 1' :Et�fi 1M: . 1 = x 10.00 = ::1vt:v:::.:vvv:v:vvv:.v�vv::.:v::.:..:::n.{•:vim,v{v+{v.•.v..:{v:....•:x:nvvvvv{vnv.:.:.v...:.::r:..nrv:.+:.v-. UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ASKSTEMIASWi :}yam.;}.::...;r ••.}}:.}:.}. '-'�{ ::� x100.00= USED APPLIANCE<400,000 BTU x 50.00 = 1 x 00.00= AIR HANDLER<10,000 CFM x 12.00 = AIsWAN:.;:::::::::::.}:;:<.;?tl,A4(�::�..�......�:........................................ ......... x 15.00 = SUBTOTAL $ ( , e4 PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT 36 ♦o n� FEE DUE =$ SIGNATURE B.�X Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675