1990, 07-20 Permit App: 90003434 ACMECHANI
Information Worksheet
JOB STREET ADDRE§S: J901
CITY/STATE/ZIP: te ` 91904
G
PARCEL NUMBER:
OWNER: T ,,-,.- 40 PHONE NUMBER: 9c 6 44��.5'
MAILING ADDRESS: J997 S.
(Street) /� (City/ mate) (Zip)
CONTRACTOR: 42, 2% 4,r // hi L - LICENSE NUMBER :.�1/2l%,2": ' /'I/4 /r7'
1
PHONE NUMBER: ga r CC/'
MAILING ADDRESS: t/7.5-.2/ .,f Gfit )4,4 GULF- -'
(City/State) (Zip)
(Street)
WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
DUCTWORK SYSTEM_ _
WOODSTOVE/INSERT
GAS WATER HEATER _ _ _ _
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU -
GAS PIPING (EA OUTLET) _
PEFRIG 1-100M BTU. (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU_
REFRIG 501-1,000M BTU _
REFRIG 1,001-1,-750M BTU
(REFRIG +1,750 8
HEAT PUMP & IR CONDITIONER70-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER 15-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP__& AIR .. CONDITIONER +50 --..TONS -
VENTILATING FANS
EVAPORATIVE COOLERS _
TYPE I 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
AMOUNT
x$10.00
x25.00=
x 10.00 =
x 12.00 =
15.00 =
1.00 =
12.00 =
20.00
25.00 =
35.00 =
60.00
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x
x 10.00 =
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 =
XXXX XXX.
JG O'v
NOTE: MINIMUM PERMIT FEB I3 $35.0
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
25.00
EQUALS_ : TOTAL.., PERMIT
FEE DUE
S J7 ote
Spokane CountyDepartment of Bultdin and Safe
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675