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1992, 06-05 Permit App: 92004065 Mechanical¢ h- AECHANIGAL PERMIT APPLICATION FORM F Info�:�ati�Wo;�ksheet JOB STREET ADDRESS: �'t l ._ ' .: CITY/STATE ZIP: :. PARCEL y NUMBER: v OWNER: -� � PHONE__. NUMBER, ^� MAILING. ADDRESS: (Street) . CONTRACTOR: LICENSE PHONE MAILING ADDRESS: L L a� �-, �� .� (City/State) :. (Zip) NUMBER: 17- - t l 0 NUMBER: .. clq Zedr. } . . (Street) _:,r�C= (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE:.: NUMBER X EACH r' DESCRIPTION OF UNITS. UNIT = AMOUNT. DUCTWORK SYSTEM - x$10.00 = WOODSTOVE/INSERT - - - - - - - - - - - GAS WATER HEATER _ _ _ _ _ _ _ _ -_ -_ _ HEATING EQUIPMENT <100,000 BTU _ x 25.00 = x 10.00. = x:12.00 = L Z_ '--beqp�m l _ _ .HEATING EQUIPMENT +100,000 BTU GAS PIPING (1 — 4 OUTLETS) _ _ GAS PIING (5 OR MORE. EACH:)- x.15.00.' x ,4.00._ x 1.00. est r, _ _ REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) REFRIG 101-500M BTU_- _ REFRIG 501—1, DOOM BTU_ _ _ _._. _ REFRIG .1,001-1,750M BTU_ _ _ _ _ _ _ _ _ x 12.00 x 20.00 = x 25.00 = x 35.00 = a REFRIG +1,750M BTU x 60.00 _ :y _ _ _ _ _ _ _ _ HEAT PUMP & AIR CONDITIONER 0-3 TONS x 12.00 _ _ 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_- —_ — —_ —_ —_ —_ —_ x 20.00 x-25.00 _ x 35.00 = X'60.00 = x.10.00 = x 10.00 —% Y= >`. __' . _ _— _— _— TYPE I HOOD (PER 12 "OR 12' PTN. OF HOOD) TYPE II HOOD x 50.00 = x 10..00 CLOTHES DRYER------------- RANGE_'> ---————— — -- —.— x 10.00 = x 10.00 = :. GAS LOG_—_—_—_—_-__--_—_—_—__—_—_--_—_—_ MISCELLANEOUS (NOT .COVERED ELSEWHERE)_ x 10.00 = x 10.00 "" _ UNLISTED GAS APPLIANCE <400,000 BTU_ _ _ x 50.00 = UNLISTED GAS APPLIANCE >400,000 BTU_ _ _ x100.00.= USED APPLIANCE <400,000 BTU x 50.00 = _ _ _ '7. USED APPLIANCE >400,000 BTU_ _ _ _ _ _ x100.00 = _ AIR HANDLER <10,000 CFM_ x 1.2.00 = _ AIR HANDLER >10,000.CFM _ _ _ _ _ _ _ x 15.00 = SIGNATURE crJ Inc Spokane Countv Department of Buildinq and Safety