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1994, 02-16 Permit App: 94001169 FurnaceMECHANICAL PE tMrrAPPLICATION FORM It( C� I Information Worksheet JOB STREET ADDRESS: 7 5 7- )4yC �s /-(e se CITY/STATE/ZIP:- 7 6 PARCEL NUMBER: PHONE NUMBER:_ 7 / OWNER: MAILING ADDRESS: (Street) 0 CONTRACTOR: J/ MAILING ADDRESS: 5 % ©.3 (Street) ; 01.1y/Sthte) (Zip) LICENSE NUMBER: - e r A 07 A l PHONE NUMBER: J-/ - )/ ' 7 Z,LY0 94: (ZIP) MECHANICAL WORK DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOGDS Tovoto1 GAS WATER HEATER GAS EQUiPM61:1T tii ,0 fro INCLUDES GAS EQUIPMENT +100,000 BTU DUCTWORK) GAS PIPING TEA OU...: T. T, BOILER/REFRIG 1-100M BTU BOILMREFFOGX101-5 ..:..�.. ... ;: BOILER/REFRIG 501-1,000M BTU BOILER/REM BOILER/REFRIG +1,750M BTU HEAT PUMP &.AtR CONDITIi`C HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT,PUMP P 8 AIR CON?ITIONEl ,1'5-30 IMF HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMP &;AIR CONDITIONER +50TO 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 ULINSTED 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 NOTE: MINIMUM PERMIT FEE IS $35.00 City/Stato) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 - x25.00 x 10.00 = x12.00 - /„,-09 x 15.00 • x 1.00 - x 12.00 is x 20.00 = x 25.00 = x 35.00 - x 60.00 = x 12.00 = x20.00 x 25.00 • x 35.00 = x 60.00 - x 10.00 x 10.00 = x50.00= x 10.0,0 x 10.00 x 10.00 = x 10.00 = x 1,0.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x15.00 = -7 - f SUBTOTAL $ 49, rJ a PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =$ 27,00 SIGNATURE_��P Snokane County Division of Buildings t 333 A.ns,,. tra Cnnirnnn W fj OO7Rf1 IR/101 d.crt...'2R7!