1992, 11-23 Permit App: 92010302 Mechanical FixturesmtbUNNILAL rnnmu AYYL 4Al1UN tUMIVI lob" 10 2
Information' Worksheet
_TREET ADDRESS: (D a..4.O -. V- -- t"`" "n
CITY/STATE//ZIPp1
:C/1 -34------%g ' PARCEL NUMBER:
OWNER: Q-Lt_L 4L PHONE NUMBER: °( 2-2 - 00 L
MAILING ADDRESS:
(Street)
(City/State) (Zip)
CONTRACTOR: S A -%t -t,. 1 PAC 4- A..` C -c- LICENSE NUMBER: R pricTo 0-R 1 o t5 7 _
PHONE NUMBER: Qin, Sao
MAILING ADDRESS: Q- '\ 9 lL. \rv. Rx. s F 1^42A4 k' 3
(Street)
i4 2.04
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
= AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIING (5 OR MORE. EACH:)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER 15-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR CONDITIONER +50 TONS
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD1
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 <10,000 CFM
AIR HANDLER >10,000 CFM
x$10.00 =
x 25.00 =
x 10.00• =
x 12.00 =
x 15.00 =
x 4.00 =
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 =
1toe
NOTE: BlIMIIPEEE IS $35.00
SIGNATURE i
Spokane County Department of Building and Safety__
SUBTOTAL -I
$ (3N
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE