1993, 07-01 Permit App: 93005387 ACPttOJECT ADDRESS: `
OWNER:
MAILING ADDRESS: -
(street) C
CONTRACTOR:
MAILING ADDRESS: _ r
(street)
W�i1[aM
�
i��
Azx_irp-
/ ZZ-'k—
(city/state) (zip)
DE )FWORK
OF UNITS
scut n—
COST
mums
AMMIE—
O FUEL BURNING APPLIANCE
= or <100.M
_lnnmwLfL=
$12
:
IIS: FUEL BURNING APPLIANCE
>100,000,
_ >,
$15
,
UNLISTED kiJEI. BURNING APPLIANCE
. s
. ..:
ITLllS L ED FUEL BURNING APPLIANCE
>400AW
$100
_ •
i > USED APPLIANCE(Must meet WSECs min. AFUE rating)
-or <400,000
$50
- s
USED APPLIANCE ust meet WSECs min. AFUE rating)
>400,000
=
$100
BOILER/REFRIGERATION
1-100M BTU
$12
r
BOUJUVREFRIGERATION
101-5wm BTU
_
$20
- s
it#. BOILER/REFRIGERATION
501-1,000M BTU
$25
:
W> BOILER/REFRIGERATION "'
1,00t -1,750M BTU
35
_ :
j BOILER/REFRIGERATION -'
+1,750M BTU
$60
:
Bl3; GAS LOG. GAS INSERT, AND/OR GAS FIREPLACE
-
=
$10
_ r
Bio' RANGE
-
=
$10
. -
1 : DRYER
-
_
M
s
Q FUEL BURNING WATER HEATER
-
$10
- •
a MISCELL ANFOUS FUEL BURNING APPLIANCE
-
=
$10
. ,
B8 GAS PIPING ea. outlet
-
$1
•
B19; DUCT SYSTEMS
-
S10
-
B20:: VENTILATING FANS
-
_
$10
- $
BZ1< AIR HANDLER ES NOT include ductsystems)
= or <10,000 CFM
=
$12
s
B22'AIR HANDLER ES NOT include ductsystems)
>10,000CFM
=
$15
s
B23 EVAPORATIVE COOLERS
-
$10
- s
$2#`TYPE I HOOD
-
$50
- :
02$' TYPE II HOOD
-
=
$10
- e
" ` HEAT PUMPIAIR CONDITIONER
o-STONs
$12
- s
B27<AIR CONDITIONER
6-15TONS
$20
- :
B 8 : AIR CONDITIONER
16-30 TONS
=
$25
- _
B29 AIR CONDITIONER
31—SOTOM
$35
r
B30 AIR CONDITIONER
+50 TONS
SW
- s
a LPG STORAGE TANK
-
$10
- :
ift WOOD OR PELLET STOVEIINSERT
-
$25
- :
- Subtotal / d�
NOTE: MINIMUM RMIT FEE IS 35.00 PLUS: PROCESSING FEE $25.00
A
--- _ TOTAL PERMIT FEE DUE $ 6�
SIGNATURE:
SPOKANE, COUNTY DIVISION OF BUILDINGS
WEST 1026 BROADWAY AVENUE • SPOKANE, WA 99260 - (509) 456-3675
mutedmechpermAnd .
PAY T01\'A
IN E A DISBURSEMENT VOUCHER
STORE N i
STORE
No. 820030
DATE C
CUSTOMER'S NAME
SALESCHECK
NUMBER
JOB I.D. NO. OR
WORK ORDER NO.
j(MOUNT
DUE
CONTRACTOR
ALLOCATION OF EXPENSE — FOR INSTALLATION OFFICE USE
ACCOUNT
NUMBER
DIV.
NO.
ADJUSTMENT
ACCT.
ACCT.
CONTRACTOR
EXPENSE
MEMO
SELLING
certify that the installations listed above have all been
completed satisfactorily in accordance with the speci
fications furnished me.
(CONTRACTOR'S SIGNATURE)
TOTAL
AMOUNT TOTALS
OK TO PAY
(AUTHORIZED SIGNATURE)
CHECK NO. 16 ��
(DATE)
14489 (See Bul. 0-187 Part 11 Supp. 8) REV. 3/91 SEARS FORMS MANAGEMENT
PAYING UNIT NO. ,�t
PAYING
UNIT NAME
(ff Different)