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1993, 07-23 Permit App 93006212 Pool Htr-Void
// Information Worksheet JOB STREET ADDRESS: p «9/0 -S - UGC CITY/STATE/ZIP: 4� bra e- GUii- 99ZI:6 PARCEL NUMBER: OWNER: ! ,ti /0,4 MAILING ADDRESS: vei0 S ,, //� (Street) CONTRACTOR: ! Ul/iX PHONE NUMBER: %Z8'-' Say bra cam,- 9fl.76. (City/State) (Zip) LICENSE NUMBER: 4r%d PHONE NUMBER: 7f--6 se-X MAILING ADDRESS: 6:- f 3 CD -Al �lff { ZZ (Street) (City/S ate) - (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) NVOODSTOVE/INSEFITMie GAS WATER HEATER liPAqiicPPIPMMTSIPPIPP9.31V400044,PPAii GAS EQUIPMENT+100,000 BTU D1ORR) GAS PIPING,(EA OUTL- BOILER/REFRIG 1-100M BTU BOILER/REFRIG 101 590M BTU:,.;: BOILER/REFRIG 501-1,000M BTU .................................... . BOILER/REFRIG 1,00E1 1,750M BTU BOILER/REFRIG+1,750M BTU HEAT PUMP:& AIR CONDITIONER 0-3 TONS HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT PUMP...:;B AIR CONDITIONER 15 30:VNS HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT' PUMP& AIR CONDITIONER +50 TOWS VENTILATING FANS EVAPORATIVE: COOLEPtS.. TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE Il HOO©. CLOTHES DRYER RANGE GAS LOG MISCELLANEOUS (NO'! COVERED ELSEWHERE UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED GAS APi?t.IANCE >4Q0;0O0 BTU USED APPLIANCE <400,000 BTU USED (APPLIANGIr AIR HANDLER, <10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATUR NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x 10.00 = x 12.00 = x15.00= x 1.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 10.00 = x 10.00 = x 50.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x1o.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = /S®Z) l QO SUBTOTAL $ 46,0U PLUS: PROCESSING FEE +$, 25.00 EQUALS: TOTAL PERMIT FEE DUE / = $ `7/00 Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675