1992, 10-06 Permit App: 92008505 Furnace, Piping mtt;HAtIVAL mum ArrLItiAIIUM Futon
Information Worksheet 6b-A YyrL?rt--
JOB STREET ADDRESS: l \-1.8 8 ..-- ' T C.2 g`____ ,I l L i
CITY/STATE/ZIP: `
PARCEL NUMBER: S�/L/ , / SO() a--)
OWNER: PHONE NUMBER: 41 )-54 - Sr( -II
MAILING ADDRESS: �-e�ri��
(Street) (City/State) (Zip)
CONTRACTOR: gA-rt.-vvws bkr#G 4-Ark,_co-L- LICENSE NUMBER: 1 isk-�-ro 0-A, t t o It Z_.
PHONE NUMBER: q.-Z z - Se. o c'
MAILING ADDRESS: G- t\g lL Priv S t!2A 4 i'3 %a 1 - ..\AAPiri.Vs C-4 2-if),‘�
(Street) (Ci)ty/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 x 10.00 =
HEATING EQUIPMENT <100,000 BTU t x 12.00 = 1 'J
HEATING EQUIPMENT +100,000 BTU t x 15. 00 =
GAS PIPING (1 - 4 OUTLETS) x 4 . 00 =
GAS PIING (5 OR MORE. EACH: ) ( x 1. 00 = L
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 $ 13' -
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT
NOTE: MI IMUM PERMIT FEE IS $35.00 FEE DUE = $ 3 B t-
SIGNATURE
Spokane County Department of Building and Safety
West 133 Broadway Avenue Spokane, WA 99260 (509) 456-3675