1993, 04-19 Permit App: 93002605 AC 33' MECHANICAL PERN[!16,7 -
l APPLICATION FORM �� 05
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V �' JOB STREET ADDRESS: /41 9/0> '- c, ?.-6 2-3 (112-6:5 '
CITY/STATE/ZIP: ilAajgel, f /L./1',41C2i) PARCEL NUMBER:
OWNER:.. c Lee_ 9th C42,1P.42_ PHONE NUMBER: 44.d- `:,208 ---
MAILING
5 08 -MAILING ADDRESS: / tit/ /D f I CSU /4..Jaiak„W4 4q'03`2
(Street) (City/State) (Zip)
CONTRACTOR*jetv24/ i-i,)tm LICENSE NUMBER: SE--fi k -& `32L7 i)
PHONE NUMBER: iig�- 908s
MAILING ADDRESS: POl ') >Jf C,' c'�i ., tog cit9c)_alj
(Street) 7 /(City/State) (Zip)
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MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBERX EACH I
DESCRIPTION OF UNITS I UNIT I = AMOUNT
DUCTWORK SYSTEM x$10.00 =
WOODSTOVE/INSERT x 25. 00 =
GAS WATER HEATER x 10.00 =
HEATING EQUIPMENT <100, 000 ETU x 12 .00 =
HEATING EQUIPMENT +100, 000 BTU x 334-19 =
GAS PIPING (1 ---4 OUTLETS) x •r.-c-=
GAS PIRING (5 OR MORE. EACH: ) x 1.00 =
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12.00 =
REFRIG 101-500M BTU :c 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 _ _ x 12.00 =
HEAT PUMP & AIR CONDITIONER 3-15 TONS _ ( x 20.00 = 27 . oo
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 HJOD) x 30.00 =
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 =
USED APPLIANCE >400,000 BTU x100. 00 =
AIR HANDLER <10, 0.00 CFM x 12 . 00 =
AIR HANDLER >10,000 CFM x 15.00 =
SUBTOTAL J $ b, -
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT
NOTE: N MUM PERMI7 FEE IS $35.00 FEE DUE -
SIGNATURE ,{ ' PAnO
IT 0'ane County Department of Building and Safety • ,,
o `
West 1 03_ Broadway Avenue Spokane, WA 99260 (5 9) 456-3675 • 1.