1992, 11-23 Permit App: 92010108 Water Heater, Piping MINIr9 -D- lc » ,
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Information Worksheet Z-612-
JOB STREET ADDRESS: %A Lola
CITY/STATE/ZIP: PARCEL NUMBER:
OWNER: C '%4A.--La-v."_._ 611/2-14�._ PHONE NUMBER: 611/2-14 (1 j
MAILING ADDRESS:"Q 3 i& t,C45 E- l
AS.,
(Street) (City/State) (Zip)
CONTRACTOR: +f3 -voN 4 OA G 4- M _ c-LICENSE NUMBER: R rv,s._-to fid...a,, 1 i c, Z_.
PHONE NUMBER: co.../_- 45-to c,
MAILING ADDRESS: 1\$LL \r+•-% Priv S t€J 4 .14'3 Cate e ..-�-��K�k Ce- e 2.o Az
(Street) (Ci y/State) (Zip)
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 t x 10.00 = Lt)`')
HEATING EQUIPMENT <100,000 BTU x 12.00 =
HEATING EQUIPMENT +100,000 BTU x 15.00 =
GAS PIPING (1 - 4 OUTLETS) x 4.00 =
GAS PIING (5 OR MORE. EACH: ) 1_ x 1.00 = I -
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 $ U.`NJ
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT
NOTE: NI MUM PE IT FEE I8 $35.00 - FEE DUE _ $ b`�_,,
SIGNATURE
Spokane County Department of Building and Safety_. ___ ____