1994, 01-20 Permit App: 94000481 Furnace ..
MECHANICAL, PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADD _R/
C.',ITY/STATErZ1P: 4. .:?. ... - c _.
di , . PARCEL NUMBER:
. _. _
OWN EPI:_j .i..t I PHONE NUMBER:____2J1_,-
MAILING ADDRESS:
(Street) . ,i(Cityldrate) (Zip)
CONTRACTOR: N) 0, .: .. or ../. °...., LICENSE NUMBER:.Ajtkrj 1-/A 0-7 4.1, I
/1/ PHONE NUMBER:S.,,3 _,/....)..,
MAILING ADDRESS: _6 / ti3 / . .)---e.--4-1_____,6.../26,..,-t--Eu.., , ..L.e:14--' ,679',0 La-.
(Strop° (City/Stato) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
,.....
r NUMBER X EACH
1
DESCRIPTION I OF UNITS _ UNIT = AMOUNT I
_____
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 =
WOOP,00.000E.NASIMISM211:!:'': E11:•::.1::::.6!':' ,!':2.:gi::: x 25.00 = i
GAS WATER HEATER x 10.00 t. !
04000 040,0211:0§ 67.110#1i#000$AiFigiviimi___ji._ x 12.00 = 117-F, 0 d
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = i
qAa.::::cetetstOOINTIVERIbli:Iiiiew:i.i• ;:i:.::IE:IiitsgilEii - x 1.00 . _
BOILER/REFRIG 1-100M BTU x 12.00 211
f.30-1104:14tP4400Gtattiliergiligiitiallg x 20.00 =
BOILEFt/REFRIG 501-1,000M 8Th ____ x 25.00 =
a°ILEF3401#0000.F.CMOCOMPIEME:IMMii!inx 36.00 mt
BOILER/REFRIG +1,760M BTU x 60.00 =
HEATPOMP.:.:4:]Ao:.0;0.0011.000i)010011a4;!.,:glii1Z;;;.: x 12.00 =
HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 =
NE4T.PU10.4ti's.R.poNototkit4oloss3:EpRitii.'-- x 26.00 au
HEAT PUMP&AIR CONDITIONER 30-60 TONS x 35.00 =
HEAT•Pt.104!Alp.00001110Nall:4$qtQt0Nii:ii;::Zigr:, - x 60.00 g2
-.....------ ..--,
VENTILATING FANS x 10.00 . li
___
E'VAPORATIVE CQOLVIS. :;::M]iii:.;.'.:...;;..:'','?':g4::;::-::',...,...::,,:::.•,...:ii'.',':i':::•:.:i:.:::' x 10.00 =
.---.1
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) _ x 50.00
TYRE"! HOOD : .•.'.:•':•:;..:'::-:.'''.•.,.•':::":!,:...:-::.•:'''.''...:',.':':'''"..E'. 'Hi.i...'.i::. : . : .: l';.: ;'''''''' x 10.00
CLOTHES DRYER x 10.00
RANGE. ,,: ..c., .::, :::: .E.]..,..L!,,:••::.;.0.:...'::'.:i::., ..:::-:::::•:•.„E,1*.'...::: :.,,,,,::::::.;niin!:.;i.• --- x1000 =
-,
GAS LOG x 10.00
MISCELLANEOUS),(NOT!,.poygRED:: LsEwHEAa:i:::: :!1:!!,, ii:i::' x 10.00
UNLISTED GAS APPLIANCE<400,000 BTU x 502)0 = ___________
1.-
ULINSTED.GAS APFL,IANCE''. 400,000.BTU.-: :.'.:i:!;::.:::'!':!:;::NE.;:.;.::1 x.100.00 = ----------I
USED APPLIANCE <400,000 BTU x 50,00 = I
US ED APPLIANCE .40C),000 BTU ,:..-i •..E0'0 . ''':, .'E,:,.:..:.-.::0.::', ..:;*•.:.•,F. xi 00.00 = ,
AIR HANDLER <10,000 CFM x 12.00 =-, ----------
AIR HANDLER?,10,00Q:CFM• ..'.•..- ' ...'..• •.. ..,.,.::',•,!...,' :•:''''.;::•E:': I x 15.00
. . -----------
SUBTOTAL
PLUS: PROCESSING FEE + $ 25.00
NOTE: MINIMUM PERMIT FEE IS $35.00 EQUALS: TOTAL PERMIT
FEE DUE = $ 37700 1
SIGNATURE C----.7.._- (,/(--e------- kj._....aL..
cnokane CountyDivision of Buildings
4.*4-Agt4 I 11'