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1992, 11-12 Permit App: 92010014 Wood Stove 5U c�2 - 001 MECHANICAL PERMif APPLICATION FORM Information Worksheet JOB STREET ADDRESS: E . I 8) 0244 we)y CITY/STATEqIP: - 0'.;•-D iWCC. PARCEL NUMBER: OWNER: ' TM`�1EE -�c.�SIC PHONE NUMBER: c14.16P "54 5I MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: ri' ` " C_ G I-FR LICENSE NUMBER: FA ICO t�-& ,1-73 L L.( PHONE NUMBER: (50ci" / // / MAILING ADDRESS: e • (131 D _33 K Yi(7)14 E'. f 1.cJ 9'9 2 c)(l (Street) (City/State) (Zip) ._ MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = W000STOVEIINSERT I ( x 25.00 = c25-op I GAS WATER HEATER x 10.00 = OAS EQUIPMENT<100,000 BTU(INCL1 DES ....-._.:_ < ig x12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = x 1.00 BOILER/REFRIG 1-100M BTU __.._. . __.. ___.. x 12.00 = 501-1.E /REFRIG 01-BOOM BTU ....::.>..::. ;.; ;:..::..:::.: :.::. x 20.00 BOILER/REFRIG 501-1,000M BTU -----•- • - x 25.00 = - BOILER/REFRIG : 00 ...17 0M tt x 35.00 = Bolt ERIREFRIG+1,750M BTU ' - • - ---1 x 60.00 fiEA?.PUMP.B�AIR CONDIT ONER 0-3.TONS x 12.00 HEAT PUMP &AIR CONDITIONER 3-15 TONS--- x 20.00 = HEAT.PUMP S�:AIR CONDITIONER 75.30:.TONS.:::::_:;::>::<:>; x 25.00 = _ HEAT PUMP 8,AIR CONDITIONER 30-50 TONS x 35.00 = HEAT PUMP$.AIR CONFIT_f0NEP+50 TONS ::;= :: :><:': x 60.00 = VENTILATING FANS .- x 10.00 = EVAPORATIVE.COOLER-igino > Erig <>>Rigg::-ii!i ...i x 10.00 TYPEI HOOD(PER 12' OR 12' PTN. OF HOOD) x 50.00 = p 1 D x 10.00 = CLOTHES DRYER x 10.00 = RONCE x 10.00 = GASLOG::.-:::.................... ....-.......----.........................------------._..................._ x 10.00 = - . ................ .................... MISCELLANEOUS(NOT COVERED ELSEWHERE x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ULINSTED:GAS APPLIANCE>400,000.BT1 ;.:. .;.::<>:>:::: x100.00= USED APPLIANCE<400,000 BTU x 50.00 = - x100.00= AIR HANDLER<10,000 CFM x 12.00 = AIRHANDLER>10,000 CFM x 15.00 = c"a SUBTOTAL $ '5 00 PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT Ca FEE DUE =$ SIGNATURE Spokane County Division of Buildings