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1990, 08-01 Permit App: 90003681 Furnace, AC MtVNANIVAL fttifal MV't 1.11,a41 Rid rUttiY1 Information Worksheet 50e JOB STREET ADDRESS: S - g o L - CITY/STATE/ZIP: PARCEL NUMBER: !_12,57/3 ... 17� _ E'r& OWNER: PHONE NUMBER: i 2-B , Z c,"7 I., MAILING ADDRESS: Slopu.-- (Street) , (Ci - !!S-tate ip) L ,, W i ONA //0 8 CONT1 ACTOR: 9 `""1 v LICENSE NUMBER:(Cir -Cp d o 'R Z PHONE NUMBER: c c(Z2- D 0 J , MA LING ADDRESS: r Ls 02 t " c�Aba u c�' { - '4` (Street) (City/State) (Zip) f MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT = AMOUNT t DUCTWORK SYSTEM x$10.00 = WOODSTOVE/INSERT x 25.00 = GAS WATER HEATER x 10.00 = HEATING EQUIPMENT <100,000 BTU 1 x 12.00 = 1�2__ HEATING EQUIPMENT +100,000 BTU x 15.00 = GAS PIPING (1 - 4 OUTLETS) x 4.00 = GAS PIING (5 OR MORE. EACH: ) 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 _ t X 12.00 = O_Ye.. 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 = EVAPORATIVE COOLERS x 10.00 = __TYPE I HOOD (PER 12 ' OR 12 ' PTN. OF HOOD) __ x 50. 00 = TYPE II HOOD 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 x 50.00 = . 4 USED APPLIANCE >400,000 BTU x100.00 = AIR HANDLER <10,000 CFM x 12.00 = i_ AIR HANDLER >10,000 CFM x 15.00 = SUBTOTAL $ , v'O-- 4 QuirrLt....y...._3.- ce‘..._D,..,....\ cA..^ PLUS: PROCESSING FEE + $ 25.00 41-'%--e'---4-1::?-' EQUALS: TOTAL PERMIT NOTE: IMUM PE IT 7117 IS $35.00 FEE DUE = $ Ylk . A 4 SIGNATURE i- i Spokane County Department of Building and Safety„,