1991, 11-19 Permit App: 91007992 Mechanical Fixtures0308
oTgl
14 a -
ET - ADDRESS :
0
MECHANICAL. PERMIT APPLICATION FORM
Ilformatjon Worksheet
Ai .LIFO. cUa ,I,_,„:
'1U
G ADDRESS:
(Street
I C? G-)
PARCEL NUMBER:
PHONE NUMBER:
Qi_799�
c teck- t'30. Ib'-Ibg5
(City/State)%(Zip)
,jJ( ICENSE NUMBER: 117t, � j PL --T I D 1)r'( 14
PHONE NUMBER:
NG ADDRESS:
P6iLo LkJ
y/State) (Zip)
,MECHANICAL WORKSHE
DESCRIPTIQNC
DUCTWORK SYSTEM
W4ODSTOVE/INSERT . -
GA$.WATER.,HEATER
HEATING EQUIPMENT <100,1)00 BTU
HEATING -EQUIPMENT +100;.000 BTU.
GAS,"PIPING, (EA OUTLET) '
REFRIG:;1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG -101-500M: BTU_ .
REFRIG501-I,000M BTU'
REFRIG 1,001-1,750M BTU
REFRIG=41 750M
EAT.,;PUMPrj&; AIR CONDITIONER 0-3 TONS ' _
HEAT.°PUMPS
&AIR;CONDITIONER 3-15 TONS _
HEATTUMP&AIR: CONDITIONER 15-30 TONS _
ATPUMP AIR:CONDITIONER 30-50 TONS
AT*PUMP:,' & ; AIR. CONDITIONER +50 TONS
NTILATING, `: FANS
APORATIVE COOLERS
YPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
YPE °°II HOOD
CLOTHES DRYER_,`
GE
T/FEESCHEDULE
NUMBER X EACH
OF=UNITS UNIT
GAS.. ` LOG
ISCELLANEOUS .(NOT COVERED ELSEWHERE)
UNLISTED.GAS APPLIANCE <400,000 BTU_
NLISTED'GAS'APPLIANCE=,>400,000 BTU
USED;IAPPLIANCE;<400,000 BTU
SED -=APPLIANCE :›400,000 -BTU
AIRNDLER <10,000 CFM
IR �HAHANDLER- >10,000 CFM
= AMOUNT
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
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 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
, co
FEE I $35.00
SUBTOTAL
PLUS: PROCESSING FEE
$ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spoka e County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 9B260 (5 9) 456-3675