1989, 08-15 Permit App: 89002800 Furnace, PipingJOB STREET ADDRESS:
MECHANICAL PERMIT APPLICATION FORM 00
Information Worksheet
S. / 7aa. AG- tea.
CITY/STATE/ZIP: S;000.444,4GJ,,.,,
i
OWNER: kerne-LAI/n.4/
MAILING ADDRESS:
94x0 (, PARCEL
PHONE
NUMBER:
D -4-7L)/ -tfhf7
NUMBER: qaa- /%9a...
(Street)
CONTRACTOR: A,VOERso4 r
MAILING ADDRESS: 8-, 13,01 712,ct
(City/State) (Zip)
LICENSE NUMBER: ANDElZSM /sea
PHONE NUMBER: fat- O %/s o
(Street)
S� kJ.n.
,� � rig./4
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE.
DESCRIPTION
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000
HEATING EQUIPMENT +100,000
GAS PIPING (EACH OUTLET:)
REFRIG 1-100M BTU (NOT A/C
REFRIG 101-500M BTU
BTU
BTU
OR HEAT PUMP)
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
EVAPORATIVE
HOODS
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
COOLERS
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
CLOTHES DRYER
RANGE
GAS LOG
UNLISTED GAS APPLIANCE
AIR HANDLER - 10,000 CFM
x$ 6.50
x 10.00
x 6.50
x 9.00
x 11.00
x .50
x 9.00
x 16.50
x 22.50
x 33.50
x 56.00
x 9.00
x 16.50
x 22.50
x 33.50
x 56.00
x 4.50
x 6.50
x 6.50
x 6.50
x 6.50
x 6.50
x 20.00
x 9.00
ta_
doy—gC,
NOTE: MINIMUM PERMIT FEE IS $20.00
Signature
SUBTOTAL
PLUS: PROCESSING FEE
+ $ Q.5.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ as,
Spokane County Department of Building and Safety
West 1303 Broadway'Avenue Spokane, WA 99260 (509) 456-3675