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1991, 04-08 Permit App: 91001632 Gas Log, PipingMEUHANIUAL rLHMI t ArrLIGA I LUN rutin' Information• Wori sheet JOB STREET ADDRESS: -r7 • 1/-3 CITY/STATE/ZIP: ,..7)( OWNER:A't/-tf/ 4 ryyt ) MAILING ADDRESS: _JO /13 J/XL /W9i PARCEL NUMBER: PHONE NUMBER: 9 Z Z- 2/ 2 (Street) CONTRACTOR: f 't '► -(0.-‘1 1 C' t MAILING ADDRESS : f . / 72-4; 7-1e/7 t. (City/State) . (Zip) LICENSE NUMBER: (Ave,2('_ / / vy) PHONE NUMBER: ( /737 6 \t 99z? (Street) •(City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE. NUMBER X EACH OF UNITS UNIT. DESCRIPTION • DUCTWORK'SYSTEM WOODSTOVE/INSERT GAS :.WATER HEATER ' GAS PIPING• '(EA .OUTLET). _ _ ;REFRIG;;: 1-100M • BTU (NOT„ A/C OR ,HEAT PUMP)t�. : REFRIG •10,1-500M • BTU_ r t • :REFRIG 501-1,.00OM . BTU _' "' ; s' c ;;;REFRIG 1 001.-1, 750M :.BTU_ :+-REFRIG 1, BTU•.‘•'. • ' •;.•A " ; ht•j�. t 4' t}i HEAT,,�PUMPJ &" AIR:CONDITIONER 0'frONS.{i._:'J;f0. •t t"4iiEAT FUMPt j AIR .3•'CONDITIONER^ =15:)TONS:; •�_i1' `HEAT 'DUMP ` & AIR; CONDITIONER'15 30: TONS !". HEAT ,PUMP, & AIR' CONDITIONER 30 50.1 TONS' ' {r HEAT' PUMP & AIR: CONDITIONER +50,. TONS..:; • :• VENTILATING' FANS • °HEATINGEQUIPMENT <100,000 BTU ;,HEATING -EQUIPMENT +100,000 BTU ". • • • EVAPORATIVE COOLERS _ TYPE 3''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 •00 1 ? s.•;l%il��a..rris j•� • • �. * AMOUNT •x$10.00 '= 00 x:!1040:= x'112.00 7 x,15.00_: x: 1.00 = x '12.0(* x20...00, x'%25.; 09 ',5,12 V•;4, x.;i3 5 A 04t x;:60.00 X`;)20:00„„'' xY25':`00{'' x ' 60';'001= x 11L00'= 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 Glia F/ P• ID0.5trt NOTE: ,MINIMUM PERMIT FEE I8 $35.00 SIGNATURE( 1'4.e f ( ?C -0c2) • SUBTOTAL. PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE . ,Spokane County Department of Building and Safety__ • IVY ilk Men NM