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1992, 11-23 Permit App: 92010227 Woodstoves
.L_\r\ , oko% L-76 oar [027-7 cn1 0 t , me- 4e,- MECHANICAL PER?PfT APPLICATION FORM Information Worksheet -15-.CAO STREET ADDRESS: .S- .3a I S �� nr��` � . • ( CITY/STATE/ZIP: S.7pIC.1 1„Ja_ q q?Ott, PARCEL NUMBER: OWNER: 1 )MO- SiblpSon PHONE NUMBER: Q. to -44761 MAILING ADDRESS: n A✓v.. (Street) (City/State) (Zip) CONTRACTOR: 1--):1Ir,, Gi-I?c icJ CF1fF✓( LICENSE NUMBER: r+ I(Orie•Ii3bL( PHONE NUMBER: (Ste) C:?G---S' i / I MAILING ADDRESS: E_ - r I J I c) .53 aA JL(p, s j --..r A„ i t_ ).“).ci C/9 2 C6, (Street) (City/State) (Zip) . _ MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) .'•°` VJOCDSTOVEJINSERT::=:`:"'>i :.::'-, ..:.... _ . GAS WATER HEATER GAS EQUIPMENT.<100,000.BTU_(INCLUDES GAS EQUIPMENT+100,000 BTU DUCTWORK) :GAS PIPING (EA:OUTLET);.::;;7:.::: -_ BOILER/REFRIG 1-100M BTU BO.. _ ,w �u1��-PJRE`r'niG-101-500t,t EOILER/REFRIG 501-1,000M BTU - EOILEWREFRIG 1;0001-1750M"BTU::_.M :.:::'_;_... td::: "EOILERJREFRIG +1,7550M BTU HEAT PUMP.&_ AIR:CONDITIONER 0-3:TONS's,°`.::::`;: HEAT PUMP & AIR CONDITIONER 3-15 TONS -- - H T PUMP,&:AIR CONDIT.IONER_15 30‘:TONS_:'.,:cz:..- HEAT PUMP & AIR CONDITIONER 30-50 TONS. ,HEAT PUMP & AFR CONDITIONER +50T0r45 VENTILATING FANS . _ -' ;EVAPORATIVE COOLERS;' :::: ...:........ TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE II HOOD CLOTHES DRYER GAS LOG MISCELLANEOUS (NOTrQvcRED,E cEWHERE:. ;;: ` UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED,GAS'APPLIANCE>400,000,BTU ":. USED APPLIANCE <400,000 BTU USED-APP.LIANCE).400;000"BTU; " AIR HANDLER <10,000 CFM AIR HANDLER>10,000 CF6i:,,fC' NOTE MINIMUM PERMIT FEE IS $35.00 NUMBER OF UNITS:" ' , X EACH UNIT - = AMOUNT ' x10.00 -=-`- a x 25.00 = SO. 00 x 10.00 = x 12.00 = x 15.00 = 'x 1.00 = x 12.00 = x 20.00 = x25.00= x 35.00 = x60.00 = x12.00 =.- x20.00 = x 25.00 = x35.00 = x60.00 = x 10.00 = x 10.00 = x 50.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = , :. SUBTOTAL S En.Op PLUS: PROCESSING FEE + S 25.00 EQUALS: TOTAL PERMIT FEE DUE = S 75 .co SIGNATURE Spokane County Division of Buildings