1992, 01-21 Permit App: 92000349 Water HeaterMECHANICAL rum! MrrLll.A1RJR (-univm
Irforma�ttiio�45\2,--2541n Worksheet 45\2,--245\2,--245\2,--2541JOB STREET ADDRESS: 5/4-7.5-1() 2 / , CJJ26- -i LO 21 (O
CITY/STATE/ZIP: 6.11, to , 09af VGWI%J PARCEL NUMBER:
OWNER: POI2Ph-41- NC . /V114L , /� n
MAILING ADDRESS: / ys-/T) ( [ C c,-vt- _
(Street)
CONTRACTOR:ACOA4A 7 (J GQQ- LICENSE NUMBER: S'f_ - ISE' - 6ife-/7740/
PHONE NUMBER: - / / ,7 O X 34/5
-,-_,e / _99�cD
PHONE NUMBER:
,50
GO a . -2-/
(City/State) (Zip)
MAILING ADDRESS:
Po 3 -7 o /
(Street)
(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 &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
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 =
1
X
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 =
/D -o0
NOTE:
SIGNATUR
FEE IS „$35. oo
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 3S-
Spokan o Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
a311VISNI
I r
t,
CUSTOMER NAME
FED. t.a . N OFFICE
SPOKANE, WASHINGTON 99220
O
W
Q
J
cn
Y
-o'_
33
'1
VI
WORKORDER OR
SALESCHECK NO.
187-04-000
0
O
W
$O
37 I
NOTE: If the Installation office unit
number is different than the SELLING UNIT NO.
colli.... •va. nnmhnr }ho fni,l
118
ACCT.
UNSOLD LABOR
DUE TO
PRODUCT ERROR
ACCT.
UNSOLD LABOR
DUE TO
INSTALL ERROR
140-87-001
x.
9
INSTALL
WHSE
CHGES
ACCT.
INSTALL
DELIVERY &
HOLING CHGES
0
b
ACCT.
03
MATERIALS
SUPPLIED
69
CHECK NO.
AMOUNT $
ACCT.
6
I
I
.69
km
vl�
o
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°
m
a
m
TOTAL
SELL
a
\O
TOTAL
M/U%
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>71
- 1- D
0Z
mo
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aD
mr
m
CO
OM
m
71n
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,m
m
m