1993, 09-30 Permit App: 93009094 Furnace, Piping1452(92- 3
.011/441A PfriA*1
JOB STREET ADDRESS:
CITY/STATE/ZIP:
OWNER:
MAILING AD
3D1
MECHANICAL...PERM-I- APPLICATION FOAM
Information Worksheet
(ALA
9?0.21-7 PARCEL NUMBER:
PHONE NUMBER:
RESS:
coXzet)
CONTRACTOR:
MAILING ADDRESS:
013- 9ocq
7S -V3
tco (5-771
(Street)
(City/State) (Zip)
LICENSE NUMBER:6CT car oeuvit
PHONE TIMBER: -5-4/ 7
a)/1- q
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS EQUIPMENT <100,000 BTU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 101-500M BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,000171;750M BTU
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0-3 TONSHEAT PUMP & AIR CONDITIONER 3-15 TONS
15-.3OTONS PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP'..4:AIRPONPITIONER0070 S..
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE III1001.7:3;
CLOTHES DRYER
RANGE
CAS L
MISCaLANEOUS (NOT COVERED ELSEWHERE
..04LISTED GAS APPUANCE <400,000 BTU
uumSTED GAS APPLIANCE >400,000 EITU
USED APPLIANCE <400,000 BTU
USED APPUANCE >400.000 BTU
e44A rtAMOLER <10.000 CFM
AIR HANDLER >10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x10.00 =
x 25.00 =
x10.00 =
x 12.00 =
x 15.03 =
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 =
x10.00 =
x 50.00 =
X 10.00 01
x10.00 0,
X10.00 Ng
X 10.00 la
z10.00 at
x50.00 as
x100.00 is
x 50.00 s.
x100.004.
x 12.00 =
x 15.00 =
//.0
-......-.........1
SUBTOTAL
,
PLUS: PROCESSING FEE
25.00
EQUALS: TOTAL PERMIT
FEE DUE
- $ q0
Spokane County Division of Buildings
Wet 1303 Broadway Avenu9 Snokne, WA 9q260 (cnoN ilr7P
•
• REGISTERED AS PROVIDED BY LAW AS A:
qtwowipooK1444
REGISTRATION NUMBER
(COL
CATc
C t CONTROLS 'INC
0 1.i
O) 151.74
SPOOOV%
SIGNATURE
ISSUED BY DEPARTMEN
.•-•••••-.
mmoospon
()I /C9/94
01115192
A 42155174
VAw
, • ,
R AND INDUSTRIES
+fit 104