1992, 07-17 Permit App: 92005447 Mechanical Fixtures \-\"--L MECHANICAL PERMIT APPLICATION FORM 9D -
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L-R , Information Worksheet
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JOB STREET ADDRESS: _ 1 �'lS' -- S `��
CITY/STATE/ZIP: PARCEL NUMBER: ,
OWNER: a ._e,.�, PHONE NUMBER: c- 2.- 2.._ - C5"- ( Sr---
MAILING ADDRESS: t -1, I - S'
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(Street) (City/State) (Zip) I
CONTRACTOR: Alt t a 4 WAk a /0 L J--,LICENSE NUMBER:.41hA %lam_* ' - t .0 6-z--_
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• PHONE NUMBER: 6 A -D H P' 11 O B a
MAILING ADDRESS: F.-Lt Sr ((.� 1,1,0_,...„4.19.,74.U4- 3 `),, cLq 2c.4
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(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT - = AMOUNT
DUCTWORK SYSTEM x$10.00 =
WOODSTOVE/INSERT x 25.00 =
GAS WATER HEATER 1 x 10.00 = � y ,"
HEATING EQUIPMENT <100,000 BTU t x 12.00 =
HEATING EQUIPMENT +100,000 BTU x 15.00 =
GAS PIPING (1 - 4 OUTLETS) x 4.00 = 't
GAS PIRING (5 OR MORE. EACH:) 2 x 1.00 = 2_°'e..... !
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12.00 =
REFRIG 101-500M BTU x 20.00 =
REFRIG 501-1,000M BTU x 25.00 =
REFRIG 1,001-1,750M BTU x 35.00 =
REFRIG +1,750M BTU x 60.00 = f
HEAT PUMP & AIR CONDITIONER 0-3 TONS _ _ x 12.00 =
HEAT PUMP & AIR CONDITIONER 3-15 TONS _ x 20.00 =
HEAT PUMP & AIR CONDITIONER 15-30 TONS _ x 25.00 = ,k.
HEAT PUMP & AIR CONDITIONER 30-50 TONS _• x 35.00 =
HEAT PUMP & AIR CONDITIONER +50 TONS _ - x 60.00 =
VENTILATING FANS x 10.00 = • "
EVAPORATIVE COOLERS x 10.00 =
TYPE I HOOD (PER 12 ' OR 12 , PTN. OF HOOD) x 50.00 =
TYPE II HOOD x 10.00 =
CLOTHES DRYER x 10.00 =
RANGE x 10.00 =
GAS LOG x 10.00 =
MISCELLANEOUS (NOT COVERED ELSEWHERE)_ _ x 10.00 =
UNLISTED GAS APPLIANCE <400,000 BTU_ _ _ x 50.00 =
UNLISTED GAS APPLIANCE >400,000 BTU_ _ _ x100.00 =
USED APPLIANCE <400,000 BTU x 50.00 =
USED APPLIANCE >400,000 BTU x100.00 =
AIR HANDLER <10,000 CFM x 12 .00 =
AIR HANDLER >10,000 CFM x 15.00 =
SUBTOTAL $ .24 4
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PLUS: PROCESSING FEE + $ 25.00
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EQUALS: TOTAL PERMIT
NOTE: MINIMUM PE IT FEE IS $35.00 FEE DUE • = $ (ellc"'-.)
SIGNATURE
cnokane County Department of Building and Safety