1993, 08-05 Permit App: 93006686 Furnace, Piping i45,03.2-D5) q3
trxeA41-5 14481- MECHANICAL PERMIT APPLICATION FoiriM
L3 `,P( Information Worksheet
JOB STREET ADDRESS: (./12.. SO 4i. )
CITY/STATE/P:, -n /az-) 7;,?.?0 PARCEL NUMBER:
OWNER: :' G'G2r°�?, PHONE NUMBER: _,,z?- .
MAILING ADDRESS: ' •
(Street) (City/State) (Zip)
CONTRACTOR: ,bba,��.- r-k. <} LICENSE NUMBER: /14.:7a.itI, 1, 9Rf J�3
_ PHONE NUMBER: (� 9�
MAILING ADDRESS: G7. 9335 ,e,G -r-t, v fj-` .
(Street) (Cit State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER I X EACH I
DESCRIPTION OF UNITS UNIT = AMOUNT
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 =
WOODSTOVE/INSERT x 25.00 =
GAS WATER HEATER x 10.00 =
GAS EQUIPMENT<100 000 RTU INCLUDES x 12.00 =
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
x 1.00 =
BOILER/REFRIG 1-100M BTU x 12.00 =
BO
LLER/R
EFR: _7
01�b.QM,:.RTU;» � ;<< >»
;> » »; ;
:>
x 20.00 -
BOILER/REFRIG
501-1,000M BTU ` ' •x 25.00 =
x 35.00 =
BOILER/REFRIG +1,750M BTU x 60.00 =
HEATPUMP & AIR:°COND.ITIONER 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 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 =
ULINSTED GAS APPLIANCE>400,000 BTU x100.00 =
USED APPLIANCE <400,000 BTU x 50.00 =
USED;APPLI,ANCE>400,000 BTU x100.00 =
AIR HANDLER <10,000 CFM x 12.00 =
AIR HANDLER >10,000'CFM x 15.00 =
SUBTOTAL $ /3,00
PLUS: PROCESSING FEE + $ 25.00
NOTE: MINIMUM PERMIT FEE IS $35.00 EQUALS: TOTAL PERMIT
FEE DUE = $ `358,
SIGNATUR. e,
Spokane County Division of Buildings