1993, 05-10 Permit App: 93003334 AC........,..,,,.. 1 J i
•
JOB STREET ADDRESS: 6 �� �''�C f � �C,/7
CITY/STATE/ZIP: 6p0 • Lk. -A f 9 /(P PARCEL NUMBER:
OWNER: (,, t'- . • PHONE NUMBER: 9L7
MAILING ADDRESS:
CONTRACTOR:
eft -L"
f , (Street)
r Cil --(_A C
ci
MAILING ADDRESS: E • L1) /(I 3 / 1(-E'q
(Street)
DESCRIPTION
(City/State) (Zip)
LICENSE NUMBER: Wre 0 NA/ 7C) rt ZJ
PHONE NUMBER: ____6-8(4-c10
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODsTOVE/INsERT
GAS WATER HEATER
GAS EQUIPMENT <100 000 I TU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA; OUT ET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG>101.500M BTU .
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG' 1,0001 1,750M•BTU
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0 3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER 1;5 30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
.........................................................................................................
HEAT PUMP &'AIR CONDITIONER•"+50 :TONS
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE' 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
ULI,NSTED GAS APPI IANCE>400,000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
.......................................................................... ............................
AIR HANDLER >10,000;CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x10.00 =
x12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
•
1--2,6D
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x1,0.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
SUBTOTAL
$ ,) C2)
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ �3�
SIGNATUR- 24/di-
Spokane
i-
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675