1991, 10-24 Permit App: 91007152 Furnace, Piping•
JOB STREET ADDRESS:
CITY/STATE/ZIP:
OWNER:
/4
MAILING ADDRESS:
t PPLA6m 4(J, h\JJiIY
,LizZoxiaation Worksheet
5, 3 0(.0 62-
k w (go PARCEL NUMBER:
PHONE NUMIIF,R: 962.-2. 9219
5 - 3 OSs 44‘-4-- (-)11-, 9 9 a/
(
(Street) CI y/State) (Zip)
CONTRACTOR: .4311,6a1)/1 c 5 1/. 6 47 met -'774-Z LICENSE NUMBER: 85MJ'4'Z.
/Alr/1/
4ow
PHONE NUMBER: 92? -09 CLO
.64m. 6-11. 9',.2ext
(np)'
MAILING ADDRESS:__A-. /2 9 ojr do4414-.
(Street)
TL.EMS,MMUMUSESMECHMEEMM20:.T
MECHANICAL WORKSHEET/ FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
(diry/State)
DESCRIPTION
DUCTWORK SYSTEM
• WOODSTOVE/INSERT
• WATER HEATER
HEATING EQUIPMENT <100,000 BTU
'HEATING EQUIPMENT +100,000
GAS PIPING (EA OUTLET)
,..REFRIG 1-100M BTU (NOT A/C
_
..REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
BTU
6R-HEA2d PUMP)
HEAT PUMP &
--HEAT PUMP &
• HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
.'VENTILATING
'EVAPORATIVE
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
COOLERS
0-3 TONS _ _
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
.TYPE I HOOD (PER 12' OR 12'
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
PTN. OF HOOD)
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_
ATA HANDLER <10,0.00 CFM
AIRHANDLER.>101000 CFM
- AMOUNT
•x$10.00
x 25.00
x 10.00
x 12.00
x 15.00
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
12.00
e.„I 00
NOTE: MINIMUM PERMT FEE •IS $35.00
SIGNATURE
4:/c A>vbReStrt)
SUBTOTAL
$ /Co . co
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE $ 00
Spokane County Department of Building_ and Safety
West 1303 Broadwav Avenue Spokane, WA 99260 (509) 456-3675