1992, 03-12 Permit App: 92001479 Furnace, Piping IIICUM4IIIIa14L r'tniv.ul Arruuu*Iun runm 6,4Ina j16
Information Works?Tet
JOB STREET ADDRESS: (0-0 (.2_
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CITY/STATE/ZIP: ��� � -_ ; a- 0 PARCEL NUMBER: 33 ' 71?
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OWNER: PHONE NUMBER: S----3'S-
MAILING ADDRESS: ,
(Street) (City/State) (Zip)
CONTRACTOR: S 4CL., LICENSE NUMBER: g-n1 t -L to (3 Z_
PHONE NUMBER:
MAILING ADDRESS: 2-LL � it/Ws-46-
(Street) (Cit State) (Zip) 9 ,
4.
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT = AMOUNT
DUCTWORK SYSTEM x$10.00 =
WOODSTOVE/INSERT x 25.00 =
GAS WATER HEATER x 10.00 =
HEATING EQUIPMENT <100,000 BTU x 12.00 =
HEATING EQUIPMENT +100,000 BTU x 15.190 =
GAS PIPING (1 - 4 OUTLETS) x 4.00 =
GAS PIING (5 OR MORE. EACH: ) 1 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 _ _ x 12.00 =
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 =
USED APPLIANCE >400,000 BTU x100.00 =
AIR HANDLER <10,000 CFM x 12 . 00 =
AIR HANDLER >10, 000 CFM x 15. 00 =
SUBTOTAL $
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT}
NOTE: MIN UM P RMIT E IS $35.00 FEE DUE = $ 3 ��
IGNATURE
k/S
Spokane Cn►►nI ' npnartment of Building and catpty