1992, 05-14 Permit App: 92003401 Heat Pumpr:5",,st,1 per, L' ' g-5 ,;,)3� Informat1k Worksheet a- 3 yo/
e.
JOB STREET ADDRESS: 5 . 3.4 22 1CI,L..F1414 5 59 Co
CITY/STATE/ZIP: �ft:lc/ -1,4 dei Ti 2.04 PARCEL NUMBER:
OWNER: }<01-.1T v G, 7q$ 61 PHONE NUMBER:
MAILING ADDRESS:
(Street) (city/State) (Zip)
CONTRACTOR t4£l 'e (Irs4-1W,LICENSE NUMBER : j)1 /CO Fay. ,,,, ( 6..
Fl
PHONE NUMBER:
•
MAILING ADDRESS: N i ( I�IAPt, c.l PC,xfRrU ‘441 9472- 32.-
(Street) (City/State) (Zip)
MECHANICAL WURksHEET/FEE SCHEDULE
DESCRIPTION OFUUNITS XUNITII = AMOUNT
DUCTWORK SYSTEM x$10.00 =
WOODSTOVE/INSERT x 25.00 =
GAS WATER HEATER x 10.00 =
HEATING EQUIPMENT <100,000 BTU x 12.00 =
HEATING EQUIPMENT +100,000 BTU x 15.00 =
GAS PIPING (1 - 4 OUTLETS) x 4.00 =
GAS PIING (5 OR MORE. EACH:) _ x 1.00 =
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12.00 =
REFRIG 101-500M BTU x 20.00 P--
REFRIG 501-1,000M BTU x 25.00 =
REFRIG 1,001-1,750M BTU x 35.00 =
REFRIG +1,750_ x 60.00 =
IIEAT PUMP & AIR CONDITIONER 0-3 TO _ 1 x 12.00 = L 2,
BEAT PUMP & AIR CONDITIONER 3-15 TONS _ x 20.00 =
IIEAT PUMP & AIR CONDITIONER 15-30 TONS x 25.00 =
HEAT PUMP & AIR CONDITIONER 30-50 TONS x 35.00 =
IIEAT PUMP & AIR CONDITIONER +50 TONS_ _ x 60.00 =
VENTILATING FANS L j 1 _ _ x 10.00 =
EVAPOPATIVt COoLP.fiS` It 10.00 -
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
TYPE II HOOD x 10.00 =
CLOTHES DRYER x 10.00 =
RANGE x 10.00 =
GAS LOG x 10.00 =
MISCELLANEOUS (NOT COVERED ELSEWHERE)_ x 10.00 =
UNLISTED GAS APPLIANCE <400,000 BTU _ x 50.00 =
UNLISTED GAS APPLIANCE >400,000 BTUx100.00 =
_
USED APPLIANCE <400,000 BTU x 50.00 =
USED APPLIANCE >400,000 BTU x100.00 =
AIR HANDLER <10,000 CFM x 12.00 =
AIR HANDLER >10,000 CFM x 15.00 =
SUBTOTAL
$ 12
PLUS: P:20CESS It1G FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
NOTE: H IHU IT E IB $35.00 FEE DUE _ $ 3 7 v'
SIGNATURE
Spokane unty Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675