1993, 02-16 Permit App: 93000867 Gas Log, Piping (k5Ici6,..0 74 t----ii , . 9-3- 6-) •
�jEUEQI�( E11L1,� 15i 8- (o MECHANICAL PERMIT APPLICATION FORM J
Information Worksheet 31
JOB STREET ADDRESS: 5 . I l a a Sky I,
CITY/STATE/ZIP: Spny_tiv 21 wa 1/a-I� PARCEL NUMBER:
OWNER: �lkclI ie_eaQ?k nAcliDe-,z,.- PHONE NUMBER: 9 a ? - -27y cR
MAILING ADDRESS:
_ (Street) (City/State) (Zip)
f
CONTRACTOR: P- ) c c ( %-1 K!] .i,f C 'Z LICENSE NUMBER: c- ,-f 1(.0 ,%, I %� Lt,(
PHONE NUMBER: (_`>C-ri) C,..2 L--, --``i l I
MAILING ADDRESS: t- • 't.:�I E? J_7F?rr;i.c.E, ~,,--rt/,l t' i,: .-� C/9LC.0--
(Street) (City/State) (Zip)
._ MECHANICAL WORKSHEET"/FEE CHEDULE
NUMBER X EACH
•
DESCRIPTION OF UNITS UNIT =AMOUNT.
I_ECTRIC/DI ICTV OR,i(SEPARATE SYSTEMS) I ' 10,00
IOODSTOVdIr:S x 25.00 = f
GAS WATER HEATER x 10.00 =
GAS.EQUIPMENT<100 000 3TU(INcUJDF.-.S x 12.00 =
GAS EQUIPMENT+100,000 BTU DUCTWORK} x 15.00 -
GAS PIPING (EA_OUTLET).. .. _ .... ...- ,..... .: . :.. ..... I ---- x 1.00 = . Op
BOILER/REFRIG 1-100M BTU x 12.00 =
C1Li-R/REFRIG 1 0 5O . •
OMs1 LTU
x 20.00 =- .
BOILE.R/REFRIG
-
BOILE.R/REFRIG 501-1,000M BTU ._-_.- -.-_..--._ x25.00
BOIL RJti FRIG 1,00011 7C(]I 1 3 U x 25.00 =
tr:DILER/REFRIG-:1,750 .1 ETU ' . ',---:*----------- --- - x 60.00 =
E. {T?Ut-9P &AIR CONDI i IO :R 0-=3 EONS x 12.00 =- I --_ _
H=AT PUR MP & AIR CnNDIT!ON 3-15 TONS E 1 x 20.00 = ' _____
'
HEAT PUMP&AIR CONDITIONER t S0 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 COOLER ' x 10.00 =
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
TYPE II HOOD .E x 10.00 = p
CLOTHES DRYER I x 10.00 = r
A.r GE =
<1 � I
GAS LCG .___I x 10.00 = /4) •v(]
MISCELLANEOUS(NOT COVERED ELSEWHERE x 10.00 --
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
ULINSTED:GAS APPLIANCE>500,000 8TU_ 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>10,000CFM
. x 15.00 =
`''ISUBTOTAL S i (.c1
-
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS:TOTAL PERMIT
FEE DUE =$
SIGNATURE
Spokane County Division of Buildings