1992, 12-01 Permit App: 92010519 Furnace, Piping MtbtUlNib
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Information Worksheet
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JOB STREET ADDRESS: �S'1 0 <4 _-
CITY/STATE/ZIP: PARCEL NUMBER: , 6
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OWNER: ei-= / . PHONE NUMBER: G2- ' a v
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: #G .it- 144%._ .•-c_ LICENSE NUMBER: R i4-us-r t-4-A, I k o t z--
PHONE NUMBER: qZi- gibe:, c,
MAILING ADDRESS: c 1\9 lL Vv, PrINI S P atcS/ ill'3 Cap n __ . C7-42.41:4:,
(Street) (Ci y/State) (Zip)
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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 x 10.00 =
HEATING EQUIPMENT <100,000 BTU le. l x 12.00 = cljav-
HEATING EQUIPMENT +100,000 BTU x 15.00 =
GAS PIPING (1 - 4 OUTLETS) x 4.00 =
GAS PIING (5 OR MORE. EACH: ) V x 1.00 = 141,
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 =
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 =
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 10.00 =
TYPE II HOOD
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 $ (-5°e-
PLUS:
°`PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT
NOTE: MINIMUM PERM FEE IS $35.00 FEE DUE _ $ .8 ate.
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Spokane County Department aE Building and Safety ___ ____