1992, 01-21 Permit App: 92000346 Range, PipingJOB STREET ADDRESS:
nntbfRnwMI. rtnrrii i Mrrut.w t iun runm
Information Worksheet
0;q --f; Qfsr-rpt"
CITY/STATE/ZIP:. ,evAr 996/6
OWNER: 4/1/w/f► S&,ti,.S / c!'I PHONE NUMBER: R 20 3, ? $
PARCEL NUMBER:
MAILING ADDRESS: SAS ti
(Street) 11
CONTRACTOR: AJ S q c
(City/State) (Zip)
LICENSE NUMBER: g1 -, rt !e -s4 -(l O (3 z_1
PHONE NUMBER:
MAILING ADDRESS: r_- (1 SH,L Luvhs 46 -
(Street) (Cit State) (Zip)gKZo�
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
=AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIING (5 OR MORE. EACH:)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
0-3 TONS _
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE)
UNLISTED GAS APPLIANCE <400,000 BTU_
UNLISTED GAS APPLIANCE >400,000 BTU_
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM
l
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.190 =
x 4.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
NOTE: MI -SUM PE IT FEE J8 $35.00
SIGNATURE 01•84.1/1/?...
Spokane Cnuf*,
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= 1
npryirtment of Building and cnfety