1990, 02-13 Permit App: 90000527 Wood Stove atlitIAR ruiM't APPLICATION FOAM
�~ R atlon Workshss$
J08 anew 11Di0R1iSS: G. / j'/ .
CiTY/6TJ►TIVZIPit .7 PARCEL MOM =_�S 0 ' c,
OWNER; �rlu2S PHONE NUMBER; 9 -y5 a
MA44,14 ADDRESS; liEL____ .
' (Street) (C1ty/Stats) . (Zip) .
' CONT : �� ice" 'f LICENSE NUMBER: 7Cv� / cs 40'21,4:-
PHONE
80 C,-PHONE NUMBER: d 8 l0 7
1I4I1ING ADDaEss: . a2--" "S
(Street) ( it'Iiy/St�to) (Zip), .
MECHANICAL WORKSHEET/FEE SCHEDULE »
NUMBER X EACH
DESCRIPTION OF UNITS UNIT = AMOUNT
DUCTWORK SYSTEM x$10.00 - I
WOODSTOVE/INSERT J x 25.00 = 25'fp -
GAS WATER HEATER x 10.00 = '
HEATING EQUIPMENT <100,000 BTU x 12.00 =
HEATING EQUIPMENT +100,000 BTU x 15.00 =
GAS PIPING (1 - 4 OUTLETS) x 4.00 • empoomommammommmill
. GAS PINING (5 OR MORE. EACH:) x 1.00 •
, REFRIG 1-10OM BTU (11Q,T A/C- OR HEAT PUMP) - x 12.00 •
' REFRIG 101-500M BTU ... _ _ _ _ X 20.00 •
. REFRIG 501-1,000M BTU_ x 25.00 =
REFRIG 1,001-1,750M BTU x 35.00 = •
REFRIG +1,750M BTU _ x 60.00 =
HEAT PUMP 6 AIR CONDITIONER 0-3 TONS x 12.00 r
HEAT PUMP & AIR CONDITIONER 3-15 TONS x 20.00 =
HEAT PUMP 6 AIR CONDITIONER 15-30 TONSx 25.00 In
HEAT PUMP & AIR CONDITIONER 30-50 TONS _ x 35.00 = ' '
HEAT PUMP & AIR OONDITIONER +50 TONS _ x 60.00 = '
VENTILATING FANS X 10.00 . ""
EVAPORATIVE COOLERS x 10.00 -
TYPE I HOOD (PER 12' OR 12' PT$. OF HOOD) ____r.. 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 15400 mi
SUBTOTAL $ c..
PLUS: PROCESSING FEE + $ 2540.
EQUALS: TOTAL PERMIT '
MOTS *IE1 PEW YES IS $35.00 FEE DUE w $54 0>
SIGNATURE ' ' 4130 ' /4/ -. mk
1 okane County Departmentof Building and Satet
West _R way Ammo Spokane, WA MU MOM 4564675