1992, 05-21 Permit App: 92003610 Mechanical Fixtures a-k5L.‘3_b5o --)f7( IVIti,I1MIIIbML Pei 4111 ArhilI ItIiUN FUHIvi c .ay 3(c \
i`k-ki T. Informsrit.n Worksheet
JOB STREET ADDRESS! E x,2.4 g S< // L v/ ( VO
CITY/STATE/ZIP:St'( �r.q+LV&A cr 2 PARCEL NUMBER:
OWNER! `) j HAI-44:1=1' 1' PHONE NUMBER:
MAILING ADDRESS!
(Street) (City/State) (Zip)
CONTRACTOR! Diva, elAfizy icy ai L LICENSE NUMBER: 11/C'C,VC\8e,t.4
PHONE NUMBER! 534 :122-g
MAILING ADDRESS!
(Street) (City/State) (Zip)
MECI#ANICAL WORksIEET/PEE 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 = t Q
HEATING EQUIPMENT <100+000 BTU i x 12 .00 = �Z
HEATING EQUIPMENT +100,000 BTU x 15. 00 =
; GAS PIPING (1 - 4 OUTLETS) 'fes x 4 . 00 = g "
GAS PIQING (5 OR MORE. EACN: ) x 1. 00
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 =
EVAPOPATIVk" COOLk'0S- -` " x 10. 00
TYPE I HOOD (PER 12 ' OR 12 ' PTN. OF HOOD) x 50. 00 =
TYPE II NOOD x 10. 00 =
CLOTHES DRYER 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 J 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 $ Od
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT
NOTE! IH E • IT FiliIA $35.00 FEE DUE _ $ ,
SIGNATURE.
Spokane Cmy Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 4564675