1993, 06-30 Permit App: 93005316 Gas Pipingwmmow WorksheetJoe STRIIW ADDRESS:- -
r.
117,
CITY/STA C-�PARC NUMBER:
,.-MGY-M. (I , v (I />/) PHONE NUMBER:,,�Z2(/ _
MAILING ADDRESS:
(Street) (City/State) (zip)
CONTRACTOR: � LICENSE NUMBER: ?nXZ-
PHONE NUMBER:-5-u�i-?
MAILING
DESCRIPTION
(Street) (City/State) (ZIP)
MECHANICAL WORKSHEETIFEE SCHEDULE
i
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE%��=
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 e
x 12.00 =
x 15.00 =
x 1.00 Q
x 12.00 e
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 e
x 12.00 =
x 20.00 e
x 25.00 =
x 35.00 a
x 60.00 .
x 10.00 0
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x50.v0 =
X100.00 =
x 50.00 =
X100.00 =
X 12.00 =
x 15.00 =
SUBTOTAL
$
PLUS: PROCESSING FEE
+$ 25.00
EQUALS: TOTAL PERMIT��
FEE DUE
=$ -= ' �'
Spokane County Division of Buildings