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1993, 04-27 Permit App: 93002944 Gas Log, PipingJOB STREET ADDRESS: MEC}:11ANICAL PERMIT APPLICATION FORM Information Worksheet E. 116117 \_Qnor•a ft,2c4(( CITY/STATE/ZIP: 5,c)O who uoo. 94 gob OWNER: Joe CrAroK°'fC,% MAILING ADDRESS: PARCEL NUMBER: PHONE NUMBER: clap- aaoL! (Street) (City/State) CONTRACTOR: EP Iri F!!ai-_'!fir lJ CrjfPie LICENSE NUMBER: MAILING ADDRESS: r_ - 'I C)-53flL< (1, (Street) _ (ZP) rgi I C 0 6; (1.1-/3 b L( PHONE NUMBER: (15C<!) qj(.- - % / / i )n:r riAi l° (City/State) I.4.)A c/%2c& MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) GAS WATER HEATER GAS,EQUIPMENT.<100;000':BTIJ_(INCL.UDES'::';;>>?isi `..__' GAS EQUIPMENT+100,000 BTU DUCTWORK) :GAS PIPING(EA :OUTGO BOILER/REFRIG 1-100M BTU ^BOILER/REFRIG;101-500M4BTU:i; BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG +1,750MBTU HEAT PUMP:& AIR: CONDITIONER 0-3.TONSj .:.' :; _`-"`. i HEAT PUMP & AIR CONDITIONER 3-15 TONS --- :HEAT PUMP &'AIR CONDITION ER:15-30TO\S:=' HEAT PUMP & AIR CONDITIONER 30-50 TONS -: HEATPUMP&_AIR CONDITIONEP:+SOTONSi' _;'`:;`; VENTILATING FANS - " EVAPORATIVE'COOLERS' =:`;:..;`;::::':::;':: TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) CLOTHES DRYER RANGE GAS LOG MISCELLANEOUS(NOT COVERED'ELSEWHERE''':: UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED GASAPPLIANCE>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 $35.00 - NUMBER OF UNITS X EACH , UNIT'. = AMOUNT x 10.00 =_ x 25.00 = x 10.00 = x 12.00 = x 15.00 = 'x 1.00 = x 12.00 = x 20.00 = - x25.00= x 35.00 = x60.00= x 12.00 =- x 20.00 = x 25.00 = x35.00 = x 60.00 = x 10.00 = x 10.00 = x 50.00 = x10.00 = x 10.00 =- x10.00 = x10.00 x 10.00 = x 10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = _. -. .... 3- .Z -o 0 . , - a aD- Do SUBTOTAL S 0%1-00 PLUS: PROCESSING FEE +$ 25.00 EQUALS: TOTAL PERMIT FEE DUE CP =5 CI�-00 I SIGNATURE Spokane County Division of Buildings