1994, 03-10 Permit App: 94001909 Furnace, Piping , .
, . . MECHANICAL PERMIT APPLICATION FORM ,
Information Worksheet -q07
JOB STREET ADDRESS: 13 _-• 0 to E.....1_12e...,ils-2J21.1.
CITY/STATE/ZIP:c II . 4„4„,-..0 1 4/ I ip PARCEL NU BER:
I
OWNER: 64,sti.,e-i a) 14.2illelata4,1-4--) PHONE NUMBER: 2_,3 5
MAILING ADDRESS: - ,------/- -
, ._.
(Street) I. " ..,(Chy/Sthte) (Zip)
CONTRACTOR:/ ...21. LICENSE NUMBER:NPkro Hf 07 J 1.
// PHONE NUMBER: #- lig 7._s
_ , ) ,
MAILING ADDRE.-SS._ _5 10 3 I •-•')" -K-19
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH I 1
DESCRIPTION _ OF UNITS , UNIT = AMOUNT
-ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 III
VV6PP$1010MgMlig: :"Igargq::::'':!.......iiiii;i;ini x 25.00 st L
GAS WATER HEATER x 10.00 = 1
oAsi•E.qtAmigto:A.**)3111:Distdimpr.s .:..4mii.giN: / x 12.00 as In . (' o
GAS EQUIPMENT+100,000 BTU DUCTWORK) . x 15.00 so
GAS..mPfNataltVIMPIPS: ::q::•lii':....i:i),::5it:: :.:\ 1 x 1.00 tal I. oa
BOILER/REFRIG 1-100M BTU x 12.00 =
•BOILtRIOatt4:101 -50b•JOIltiii :::0;:r;1...: nlidalagg•, x 20.00 =
BOILER/REFRIG 501-1,000M BTUx 25.00 =
BOILERIRE.M000004;700t.AV11/1711 ..i::::$...!:::ii':;ii::11:;r:r:: x 35.00 is
__ _
BOiLER/REFRIG +1,750M BTU x 60.00 _
112
HEATpvmsz,:::kAtri' cn\lprr(000,1. 4.3t:(0$:::!i,giiip;R::ir- x 12.00 . _
HEAT PUMP 8 AIR CONDITIONER 3-15 TONS x 20.00 sz
HEAT PUMP &AIR CONDTPONERTS;;W*TOOMM„....... V: x 25.00
as
. .• • • . .......
HEAT PUMP & ARR CONDITIONER 30-50 TONS x 35.00
HEAT PUMP & AIR CONDITIONER.4so.ToNs '..:511.M:::,.- x 60.00 .
...
VENTILATING FANS x 10.00 =
EVAPORATIVE COOLERS.:0):: . :. • ..'.'. •.,: . •, .'-'.11.'. .'.',•''''is::'• $__ i x 10.00 . 1
TYPE i HOOD (ri
ER 12' OR 12' PTN. OF HOOD) x 50.00 =
TYPE II HOOD . . .. - . ..• . - ' • .• . . -,...*:'''1'..::. _i I x 10.(i0
CLOTHES DRYER L_____ x 10.00 = --- ---; •
_
RANGE ' •- ..,- - I x 10.00
GAS LUG i ;,' 10.00 = I
---------1
..--.-....---..-------4
MiSCELLANEOUS NOT•COVERED ELSEWHERE:...',....:..0- H _0 x 19.00 . _ _ei
UNLISTED GAS APPLIANCE <400,000 BTU - x 50.00 =
ULINSTED GAS APPLIANCE>400,000 BTU ' ..:•••• .'....'..:.' • xi 00.00 .
USED APPLIANCE<400,000 BTU x 50.03 = _
USED APPLIANCE>400,000 BTU-.. • •... . •: . . •., .-.• , ,•••••• - .1 xi oo.00
A!! HANDLER <10,000 CFM x 12,00 = 0
AIR HANDLER >10,000 CFM . - • . ., . ..:.:*: ..' x 15.00 =
-------
_
SUBTOTAL $ I?.QC)
PLUS: PROCESSING FEE 4- $ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT -1
FEEDUE = $--)
SIGNATURE -- . - W- 6-1
Snokane County Division of Buildings
AA/A Annan inc . Ace 41C-7C