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1992, 11-30 Permit App: 92010407 Gas Log, Piping MECHANICALqR-)0-1 (5-7 PERMIT APPLICATION FORM Inforriiatian WoJ'icsheet � �� JOB STREET ADDRESS: I=- 6 L013 15-1-k CITY/STATE/ZIP: 5eb�A- J1 wa R 1 d- I- PARCEL NUMBER: OWNER: 1--e-1- r.1 1 .2,A r-. PHONE NUMBER: 5 3 `-) - 3 ?-/-I MAILING ADDRESS: r� (Street) (City/State) (Zip) CONTRACTOR: [ i4 I C.t G r41 jc.nl C.f,J f File LICENSE NUMBER: ri+ IC-0 671C-1/3 b LA cC PHONE NUMBER: (..5-()(1) c, �,--(C'i I J MAILING ADDRESS: t-E . r i 31 n 5.P K�H3Lc-C, <S j^4-...,t,,r c I.,..%:,9 c79 L C(E., (Street) (City/State) (Zip) ._ MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = WOODSTOVE/INSER� x 25.00 = GAS WATER HEATER x 10.00 = GAS EQUIPMENT<100 ......... ...................:..................�OE}0��'11�iNCL�1DES; �:: :.::.> ::'<;':: x12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = GAS PIPING.(EA.JUTL - ... .: ( x 1.00 = / cpb BOILER/REFRIG 1-100M BTU x 12.00 = BOI REFRIG 701:-500M BTJ _ x 20.00 = BOILER/REFRIG 501-1,000M BTU ----- :_.._...._-._ x 25.00 = - ---fes-- -- 00 - - --: -- - - - BOILERfREPRIG 701::1750M B x 35.00 = - ._ . BOILER/REFRIG+1,750M BTU = - _-.- x 60.00 = - NEAT'DUMP&AR CONDITIONER U-3 TONS x12.00 =_ ..-. HEAT POMP &AIR CONDITIONER 3-15 TONS --- -- x 20.00 = HE=AT PUMP&AiR CONIi1TTONER 15-30 TONS x 25.00 = HEAT PUMP&AIR CONDITIONER 30-50 TONS- -- x 35.00 = :HEAT PUMP&AIRCONDITIONEP+S0 TONS:>_<:` ` .;-: o x 60.00 = - VENTILATING FANS _ x 10.00 = EVAP RATIV L _ _..... - .. _......_COO ERS,>:: :>=::»__;:::<»=:;:::<::::>:::::»;`:::_::: ::::::=::::>:>:_>::>:':<;»::>:::_:. - _...:.......,............................... .....--- :......--------------_-----�------..:-. ..:---r•-- -----�---..:......... x 10.00 - TYPE I HOOD(PER 12' OR 12' PTN. OF HOOD) x 50.00 = :TYPE i HOOD .,<;.::::.:;-.: - 0.00 = ::- x 1 CLOTHES DRYER x 10.00 = aANCE . : x 10.00 = GAS LOG ( 10.00 I) -0 x = C 042, 'MISCELLANEOUS(NOT COVERED ELSEWHERE x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ULINSTED 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 CHANDLER>104000 CFM: x 15.00 = '"` SUBTOTAL $ ) 1 -Dl] l'.PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT b� FEE DUE =$ k' BT1:1- • Cr O_cl?. I� Spokane County Division of Buildings