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1992, 10-12 Permit:92008780 Mechanical• Mtt:HAN1t;AL rtH1V11J ArrLIGAIIUN I"UKIVI l� Information Worksheet JOB STREET ADDRESS: )&- ct-t cz) CITY/STATE/ZIP: C� ��_�.::� PARCEL NUMBER: OWNER: 1� PHONE NUMBER: Cl' 2-0 33 -L- MAILING ADDRESS • ��-►� (Street) (City/State) (Zip) CONTRACTOR: 13LICENSE NUMBER: R Acv -m I t p L - PHONE NUMBER: R L L S� o , MAILING ADDRESS: LL fir,., S E^-''��c� J-� 3 (Street) (Ci y/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT = 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 _ _ _ _ _ - _ HEAT PUMP & AIR CONDITIONER_ 0-3 TONS _ HEAT PUMP & AIR CONDITIONER 3-15 TONS _ HEAT PUMP & AIR CONDITIONER 15-30 TONS _ HEAT PUMP & AIR CONDITIONER 30-50 TONS _ HEAT PUMP & AIR CONDITIONER +50 TONS' _ VENTILATING FANS_'_ _ _ _ _ _ _ _ _'_ _ 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 _ _ _ _ x$10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = 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- 0.00_MISCELLANEOUS x 10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = LO � [� _ _ _ SUBTOTAL . $ . PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT NOTE: MI IMUM PE IT FEE IS $35.00 FEE DUE = $ 3 SIGNATURE Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (5 9) 456-3675