1993, 04-30 Permit App: 93003080 Mechanical Fixtures:LA51 ol. JIV }+;I ;iiillill.7..,, :'aylid4.P A1114'n1i;Ji4gppm ovum
L POZCLIK1 ('C A•.i::.Culmation worksheet
•:;,i,. JOB STREET ADDRESS: 27/9 15-- /7lati.'n
CITY/STATE/ZIP:
Y d.4n�44../77.,n...9-04 PARCEL NUMBER: p
Y
PHONE NUMBER: 2
t o72A
OWNER: Dave pov,>`y
MAILINGIADDRESS: �� sQ
(Street)
CONTRACTOR: ANDERSON'S SHEET METAL
LICENSE
PHONE
(City/State) (Zip)
NUMBER: ANnpR4M1 a
NUMBER: 928-0960
MAILING ADDRESS: E. 13903 TRENT AVE. SPOKANE WA 99216
(Street)
MECHANICAL
DESCRIPTION
(City/State)
(Zip)'
WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
.GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
„HEATINGEQUIPMENT +100,000 BTU
"'GAS PIPING (EA OUTLET)
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
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
•
'HEAT PUMP &
HEAT PUMP &
HEAT'PUMP &
HEAT PUMP &
HEAT,PUMP &
VENTILATING
'EVAPORATIVE COOLERS
.TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
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 HANbLER'>10,000 CFM
2
= 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
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 =
3
/a
• i 1: ,'1
• NOTES MINIM M P RMIT FIFE I00
` SIGNATURE i f
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
SUBTOTAL
$ 2S °�
PLUS: PROCESSING FEE
H $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE