1993, 03-09 Permit App: 1993, 03-09 Water HeaterIrformatio
JOB STREET ADDRESS:
CITY/STATE/ZIP: % ))/ AA/
OWNER:
1D'I D41 -y5-
OWNER: 5
PARCEL NUMBER:
/ C PHONE NUMBER:
BER :�5274,,..
MAILING ADDRESS : J ` // A 1 ()lett idAt. �•/
(Stree//) (C ty/State's (Zip)
CONTRACTOR: (f.5 .41/e._'') (-) tU/ / LICENSE NUMBER:, -5/5-,44 5e-Aj. j(/j
PHONE NUMBER:_ •; &r6!7
MAILING ADDRESS:_ Pip.. 37e7 `� Q/il/11.� '4 9G
(Street) (C ty/State) / (Zip)
r. .. _
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
NUMBER X EACH
OF UNITS UNIT
= AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 ETU
GAS PIPING (1 --4 OUTLETS)
GAS PIING (5 OR MORE. EACH:)
REFRIG 1-100M BTU (NOT A/C OR EAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
0-3 TONS _
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HJOD)
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 <10,0430 CFM
AIR HANDLER >10,000 CFM
x.110.00 =
x 25.00 =
x_ 10.00 =
x 12.00 =
15.
xr-�-
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 =
NOTE: 'MUM PE IT PEE IS $35.00
SIGNATURE A/44_,
Spokane County Department of Building and Safe
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
i.T h t
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
•
_. $