1994, 03-10 Permit App: 94001907 Mechanical Fixtures -
..
MECHANICAL_PEHMIT APPLICATION FORM • qi-1 - 1c107
Information Worksheet
JOB STREET ADDRESS: 1 3 0 J Lr E - �-w.�,rr
h,
CITY/STATE/ZIP: cp oJati.,, _ 1 7(1 I & PARCEL NUMBER:
OWNER: __c 0 J4 a -r -_ PHONE NUMBER:_
MAILING ADDRESS: ..,.____-__
(Street) :jCi r,/State) (Zip)
CONTRACTOR:.ry'-t? /ci...ec, 1 / LICENSE NUMBER:
1/ PHONE NUMBER 5 7 9 -11 y 2 ')
MAILING ADDRESS: E . • . ' . .
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT = AMOUNT
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 •
WOCDSTO'V�.Stket. ....; ; : , ° x 25.00 x
GAS WATER HEATER / x 10.00 = /61 - 00
GAS EQUIPM T+d t4o aTU i1NCILUDES ::. / x 12.00 • /., , 0 0
GAS EQUIPMENT +100,000 BTU DUCTWORK) x 15.00
GAS PIPING"'`(EA OUTLE'11: > ° .. ... I x 1.00 ,. j n a
BOILER/REFRIG 1-100M BTU .. x 12.00 a
BOILER/REFRIG019 1 M; 0g li >> Un:.^.k. ' x 20.00 sr r-
BOILER/REFRIG 501-1,000M BTU x 25.00 =
BOILEFi/REFRiG jet # 1 00:V : 9 f t:: x 35.00 s
-
BOILER/REFRIG +1,750M BTU x 60.00 m 7
HEAT;PUMP:&.AIR COWD1T1ONfER L0-3 TONS :; x 12.00 =
.......
HEAT PUMP & AIR CONDITIONER 3-15 TONS x 20.00 as
HEAT:PUMP&'AIR CONDITIONER 1;5.30 TONS £t..> Y` -, x 25.00 I.
HEAT PUMP & AIR CONDITIONER 30-50 TONS x 35.00 .
HEAT PUMP& AIR CONDITIONER+50 TONS ` x 60.00 Q
VENTILATING FANS x 10.00 r -__
EVAPORATIVE COOLERS �� x 10.03 =
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00
TYPE II HOOD • x 10.00 :__
CLOTHES DRYERx 10.00 =
MANGE __ __�_ x 10.00 r �'.._�__� �-I
•
GAS LOG ��. x 10.00 = I --a
MISCELLANEOUS (WOT'COVERED ELSEWHERE ___..._ _____ x 1,0.00 = --_--
UNLISTED GAS APPLIANCE <400,000 [3TUx 50.00 = _
MASTED GAS APPLIANCE>400,000 BTU • • x100.00 =
�_�_
USED APPLIANCE <400,000 BTU _ x 50.00 =
USED APPLIANCE?400,000 BTU x100.00 = �__�
AIR HANDLER <10,000 CFM __- x 12.00 = -
AIR HANDLER >1O.000 CFM x 15.00 =
SUBTOTAL $ q, 0_0Y
PLUS: PROCESSING FEE + $ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE = $ b .Q O
SIGNATURE __ / 0---ti-
Snokane County Division of Buildings
1303 ' avar%.." Ori,,. IA/A enncn icnn't Ac 407G