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1991, 12-26 Permit App: 91008789 Mechanical Fixtures '°'° ,`MECHANICAL PERMIT Al PLICATION FORM Information Worksheet .. JOB:STREET ADDRESS: W�� SYR( . 0 ..T CITY/STATE/ZIP: 3/Lo/6 pi--t" PARCEL NUMBER: OWNER: !rt?(//e/--( PHONE NUMBER: MAILING ADDRESS: ; (Street) (City/State) (Zip) CONTRACTOR: 4I -( 6 a", c ?c41 r;LICENSE NUMBER: /9/lr41.SS.e/6�9 Ark/ ,�l/ ,v /7,,� PHONE NUMBER: 9ZZ- 3705/ MAILING ADDRESS: ,v ►�H -5,1-e>/4/--e 4(//51- 7P2-0 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = :?rRv? _.ti}t/#} iO{t + ?}i ..iNLj9E_ 4v. ...rxx/5 .00 = GAS WATER HEATER x 10.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = 1 '`r' r'.ul - ?' 4 ti...f.'}'F�...:. g 4:-i-?;r.;:'c: x 1.00 = ;i.::.v.- :iii;:?o-:t:.::•::•:}:�,:ca<x,. 6'°,�..s�i�' '7�,?G:i:..-�'w.`::c}r}:,:}.. BOILER/REFRIG 1-100M BTU x 12.00 = •:: • - a,,..�.,i}}.::f,.'„�•.: <:.�h:`' h.,;i}r :�?v ��,..��:;'?::<:: .:.�:�• �x 20.00 BOILER/R�EF_RIG 501-1,000M BTU x5./00 = }o•XY b yA t.V'.t�'2..,.ai _-7:4 4.4:;, ,. .'. 7:.,20,75-!-A.::5• x 35.00 BOILER/REFRIG+1,750M BTU x 60.00 = ',q, ...7..7i7 p .. �` � '.W �. �a`W��v✓ 4- ..A �.t<:�<y.•��.h1�./�% y rarv:1S' aa x 12.00 = HEAT PUMP&AIR CONDITIONER 3-15 TONS:.. _. x 20.00 _ . .. 3:�.'ea:ra,t' .n 1 r v. i' s .6-a ««: x 25.00 HEAT PUMP&AIR • +E . CONDMONER 3050'TONS .o.; .+: x 35.00 = Pv, i.i ,tR \ ,t _ a1 ::£ g �;iYror ;% ` + .X Q1/.W0;= VENTILATING FANS _ x 4 TYPE I HOOD(PER 12'OR 12' PIN.OF HOOD) • x 5000. - • (?2,:.�b ;' ;�> . .';fit,° . x 10.007.= CLOTHES DRYER x 1000 -= — , x10.00 GAS LOGx 10.00 = - t`- v ',( 44 10 - ls, ..�� _,);; >:°. .:.:i X10.00 - UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = . , ._I,.a .ijR:i 4?':f'{ .x�,.?i,vi a?,::k b b. .., , o' atx100.0081 USED APPLIANCE<400,000 BTU _ x 50.00 = .Sr �' w€' " ;�r6 4 4'e ' a �: x100.00 AIR HANDLER<10,000 CFM x 12.00 = �•��:� �. .'" '3'' x 15.00 = •:..WWWW........::.,:,.,,.�.,nM. .-,..v:.:.::_;u�.nr::fi:::::::;:>P.. x:Yci;::;•'•:..�«'`'.,:. F,i?: ,.•�;�wX�' ' SUBTOTAL $ 13.ao PLUS: PROCESSING FEE +$ 25.00 - NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS:TOTAL PERMIT 3 ... • FEE DUE =$ - SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509)456-3675