1993, 01-11 Permit App: 93000125 Mechanical Fixtures L-N -z,4 '0'0 s
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>01'4°Q T_` ,-- Worksheet
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JOS STREET �£
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CITY/STATE/ZIP: Sc -we ,W ct, clicr2sip PARCEL NUMBER:
Ut' 't d� Ye7714. 71--e_A---) PHONE NUMBER:97?(27- 7/q`f a
OWNER �-c _
MAILING ADDRESS: //6---2. E ' /� `- Spo/ meq. 99..)--- ,
(Street) (City/State) (Zip)
CONTRACTOR: PS 44tra06.31 grkr *- M.`r LICENSE NUMBER: R -rt, ti_ik t i o a z._
PHONE NUMBER: RIs.. Soo c1
MAILING ADDRESS: g. %\S lL lrv, Ay.a i E L aa c.Q il.3 Caps 14-...r,...-a.\A.A.o t.vs 4-424:3,,
(Street) (City/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 = /o ,
HEATING EQUIPMENT <100,000 BTU x 12.00 = /�.oc>
HEATING EQUIPMENT +100,000 BTU x 15.00 =
GAS PIPING (1 - 4 OUTLETS) x 4.00 =
GAS PIING (5 OR MORE. EACH: ) 2 x 1.0 0 = a -o 0
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 HOODS _ 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 BTt1 _ _ 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 =
I
SUBTOTAL $ '4- ao
PLUS: PROCESSING FEE + $ 25.00
J EQUALS: TOTAL PERMIT d�
MOTs: •4 "• ' T {i $25.00 FEE DUE • $ l'9
SIGNATURE d'-2
Spokane County Deoartseet of ! aid def-. -