1993, 03-09 Permit App: 93001349 Range, Pipingot9-JO BSTREET ADDRE. S
CITY/STATE/ZIP'
OWNER:
MAILING ADDRESS:;
I formatio Worksheet
t--
17‘65380
PARCEL NUMBER:
PHONE NUMBER
ez
A24 f9
(Street) ,'City/State (Zip)
CONTRACTOR'Z(J.�1' r>>
MAILING ADDRESS:
ICENSE NUMBER: vG AA"-S/e 47„24/7-
PHONE
%2/ `PHONE NUMBrR:
(Street) _ (City/State) (Zip)
MECHANICAL WORXSHEET/FEE SCHEDULE
NUMBER I X EACE
OF UNITS UNIT I = AMOUNT
ley Zed ''7d. -2n
DESCRIPTION
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 ETU
HEATING EQUIPMENT +100,000 ETU
GAS PIPING (1 -4 OUTLETS)
GAS PI};ING (5 OR MORE. EACE
REFRIG 1-100M BTU (NOT A/C
REFRIG 101-500M BTU
:)
OR HEAT PUMP)
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
VENTILATING FANS
EVAPORATIVE 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
PTN. OF HJOD)
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 <10,0.00 CFM
AIR HANDLER >10,000 CFM
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
15
x
�
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 =
/(9 00
NOTE: IMUM PERMIT PEE .IS $35.00
SIGNATURE' L
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Department of Building and Safe
West 1303, Broadway Avenue Spokane, WA 99260 (509) 456-3675