1992, 12-09 Permit App: 92010804 Mechanical Fixtures MtunAr gbAL rttuv I rirruw►i iuN romacer r"t--
Tntormation Norkshoot
JOB STREET ADDRESS: N t 2-(, L_
CITY/STATE/ZIP:
PARCEL NUMBER: '75iu1.a e5/9
OWNER: t - CLA-9- )-9- 2-e-^---N-- PHONE NUMBER: i 2_`1 --- 7....C.c)
MAILING ADDRESS: ._..- a Q-- --si,
(Street) (City tate) (Zip)
CONTRACTOR: A A-It-stpN1 r}-G 4 Ark,` c_ LICENSE NUMBER: R rt-id._-ro 0_,,ti l to % z__
PHONE NUMBER: co_l_ . 5m o c,
MAILING ADDRESS: a 1\9 u- Priv& F l`42-A4 6.3 a N- t.4 44 2Q,(
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT = AMOUNT
DUCTWORK SYSTEM x$10. 00 =
WOODSTOVE/INSERT x 25.00 =
GAS WATER HEATER l x 10.00 = L b-
HEATING EQUIPMENT <100,000 BTU `C x 12 .00 = ( Z �
HEATING EQUIPMENT +100, 000 BTU x 15. 00 =
GAS PIPING (1 - 4 OUTLETS) x 4 . 00 =
GAS PIING (5 OR MORE. EACH: ) 1___ x 1.00 = 1 :c. _.-
REFRIG
: _REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12 .00 =
REFRIG 101-500M BTU x 20.00 =
REFRIG 501-1,000M BTU x 25.00 =
REFRIG 1, 001-1,750M BTU x 35.00 =
REFRIG +1,750M BTU x 60. 00 =
HEAT PUMP & AIR CONDITIONER 0-3 TONS _ _ x 12 . 00 =
HEAT PUMP & AIR CONDITIONER 3-15 TONS _ x 20. 00 =
HEAT PUMP & AIR CONDITIONER 15-30 TONS _ x 25. 00 =
HEAT PUMP & AIR CONDITIONER 30-50 TONS _ x 35.00 =
HEAT PUMP & AIR CONDITIONER +50 TONS _ _ x 60. 00 =
VENTILATING FANS x 10.00 =
EVAPORATIVE COOLERS _ x 10. 00 = _
TYPE I HOOD (PER 12 ' OR 12 ' PTN. OF HOOD1 __ 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 BTU_ _ _ x100.00 =
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 $ 240-J
PLUS: PROCESSING FEE + $ 25. 00
!
EQUALS: TOTAL PERMITt ''
MOTE: MINIMUM FERMI FEE ;8 535.00 FEE DUE _ $ �Lt '
SIGNATURE .2(4_ P -
Spokane County Department of Boning and Safety_- ___ ____