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� _
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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
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PHONE NUMBER: c c(Z2- D 0 J ,
MA LING ADDRESS: r Ls 02 t " c�Aba u c�'
{ - '4` (Street) (City/State) (Zip)
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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„,