1995, 04-07 Permit App 95002088 Wtr HtrIrformatior. Worksheet
JOB STREET ADDRESS: (4/14- S T .&
CITY/STATE/ZIP: SktAA/ / / PARCEL NUMBER:
CWNER:. , JT J C' .--
MAILING ADDRESS: 540` 4-5 /tk"
CONTRACTOR:
PHONE NUMBER:
(Streit)
adeld S L 0/1
LICENSE
E. SE
/3204"
PHONE
MAILING ADDRESS: & 2c,/C2
(Street) (City/State)
(ZiP)
MECHANICAL W RKSi;EET/FEE SCF?DULE
DESCRIPTION + C,F NITS I XL. EACHi�liCT'ri0 SYSTEM
T AMOUNT I
DUCTWORK J__!XiC.00 -
_ I
WCODSTCVt f I;sSERT
GAS WATER HEATER _ 4EC_ A — — _ ------ x 2 5 . C C
HEATING EQUIPMENT <10C OCOC L�Z / — C. CC = 1 23
= N G E Q MENT ETU ----- 12
HEATING EQUIPMENT 4-100, CCC ETU - - - - - Ix 12.00
2 . GG _
- - - .09S =1
GAS PIPING (1 - 4 OUTLETS) _ _
!-
GAS PIPING (5 OR MOIRE , EACr. ) — _ x� —,
REFRIG 1-100M BTU (NCT A/C CR HEAT PUMPx 1.00 =
REFRIG 101-500M BTU) x 12.00
REFRIG 501-1,000M BZ�U :. 20.00 =
REFRIG 1, 001-1, 750M BTU - - - - x 25. CC =
REFRIG +1,750M BTU x 35.00 =
HEAT PL'M1 & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER C-3 TONS ix 50.0C =
x 12.G0 =
HEAT PUMP & AIR CONDITIONER 15-3C TONS -
x 20.00 =
HEAT PUMP & AIR CONDITIONER 30-50 TONS L5.0C
HEAT PUMP & AIR CONDITIONER +5C TONS-
-- Ix 35.00 =I
VENTILATING FANS x 10.00 J+
EVAPORATIVE COOLERS x 10.00 = I
TYPE I HOOD (PER 12' OR12' PrN. OF H.)CL))------- x 10.00 =1
TYPE II HOOD 50.G0 -i
CLOTHES DRYER -----__._ x 10.0C = �"
RANGE x 10.00 =,
eWfITZ, zr
Lj J7
2g(- 33
(City/State) (Zip)
NL'�EEFc: OGt/� S P / g3 /
NUMBER: f
9924
GAS LOG
MISCELI.ANEC,,US (NOT COVERED ELSEWHERE)
UNLISTED GAS APPLIANCE <400,000 BTU _
UNLISTED GAS APPLIANCE >400, 000 ETU_ -
USED APPLIANCE <400,000 BTU -
USED APPLIANCE >400,000 BTU
AIR HANDLER <10, 0400 CFM
AIR HANDLER >10,000 CFM
------------------
NOTE : MIN
SIGNATURE
35.00
fx 10.00 =
_._ _. __._ x 10.00
0.00
I
J x 10.00
x 50.00 =1
x100.00 = +
x 50.00 _ I �'r"-'
Ix100.00
x 12.00
x 15.00 ^I— 1
SUBTOTAL ---------------1777-1
PLUS: PROCESSING FEEL+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE _ $� J
Spokane County Department of Building and Safe •
West 303 Broadway Avenue Spokane, WA 99260 Sty
. � (09j 456 36?5
•