1992, 02-27 Permit App: 92001124 Mechanical Fixtures ret+irrwnrr,Nrr rtrsrru r urrur;.w r run runmbcidA.La
Information Worksheet ,
JOB STREET ADDRESS: N j o'4
CITY/STATE/ZIP: PARCEL NUMBER:
le <4L_'is
OWNER: &rNe PHONE NUMBER: 1
MAILING ADDRESS: j_o. - - e7
(Street) (City/State) (Zip)
CONTRACTOR: SWL.1q-A10._ LICENSE NUMBER: gicricrb
PHONE NUMBER:
MAILING ADDRESS: t5i- LI 9-1,L C4."NS
(Street) (Cit State) (Zip) 9 ,
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 = Ib'e_
HEATING EQUIPMENT <100,000 BTU x 12.00 = t2�
HEATING EQUIPMENT +100,000 BTU _ _ _ _ x 15.190 =
GAS PIPING (1 - 4 OUTLETS) x 4.00 =
GAS PIVING (5 OR MORE. EACH:) -; x 1.00 = 3�_
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 50. 00 =
TYPE II HOOD x 10.00 =
CLOTHES DRYER 1 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 $
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT^
NOTE: M NIMUM PE IT FEE IS $35.00 FEE DUE = $ Gape-
,
SIGNATURE
Spokane Cn►►nfi, npnartment of Building and cifety