1991, 12-13 Permit App: 91008623 Mechanical FixturesJOB STREET ADDRESS:
CITY/STATE/ZIP: S dam-
OWNER: Oeke pen+cnlef
MECHANICAL F Mfr APPLICATIO, , FORM
Information Worksheet
5.2%775. geeghawi
wA- 44037
MAILING ADDRESS:
CONTRACTOR:
PARCEL NUMBER:
255/13 --elk'
PHONE NUMBER: Q 2.6,- on
Street)
MAILING -ADDRESS: 63 0-.69 ! %.7,7
(Street)
(City/State) (Zip)
L LICENSE NUMBER:Aje FL NA 7
o;ei.z.,E NUMBER: 3 s & 79k
793c ..0
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/It SERI s'<: -s j <_:
GAS WATER HEATER
GAS EQUIPMENT:<1_00.;000 BT,U_'(NQLUJ
GAS EQUIPMENT+100,000 BTU DUCTWORK)
r
GAS;PIPItiG�(EA:.OUTcEna
BOILER/REFRIG 1-100M BTU
8Q1t Efitt G:1O1.= OOA,t
BOILER/REFRIG 501-1,000M 8TU
`BCIL:ERiBEF y OOO. i gl
BOILER/REFRIG +1.,750M
HEAP'etA A ATeT NDI7lONE 1" TL)nIS• ;
HEAT PUMP & AIR CONDITIONER 3=15 TONS .1-1..
HEAT PUMP& AIR CONDITIONS w4 d"!O iO S ,\.,
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT B`4i,FC OND(7'IOt1 };t45( TONS
VENTILATING FANS
EVAPORATIVE COOLERS;:,
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPEILHOODzz`"
CLOTHES DRYER
RANGE
GAS LOG
MISCELlANEOUS,(NOT COVERED_ELSEWHERE'>:
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED APPLIANCE ?4.00OOOBTU=_
USED APPLIANCE <400,000 BTU
USED: APPLIANCE;400;0001311.1!,
AIR HANDLER <10,000 CFM
AiR HANDLER>10,000.CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
/
x 10.00 =
x 25.00 =
•x10.00 =
x 12.00 =
x 15.00 =
x1.00 =
x 12.00 =
x 20.00 =
x25.00=.
x35.00'=;..
I
/
0
,
/ 4 ...::......:...
*60.00 =/
x 12.00 =,'
x 20.00 -
x25.00 =
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 =
x10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
-- P
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$
Spokane County Division of Buildings