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1991, 01-30 Permit App: 91000298 FurnaceET ADDRESS: TE/ZIP: ``=Y MECHANICAL PERMIT'APtL1CATION FORM Information Worksheet PARCEL NUMBER: PHONE NUMBER: G ADDRESS: ONTRACTOR : 6 -Fa (Street) (City/State) (Zip) LICENSE NUMBER: rT,.. PHONE NUMBER: 246,7 C.O/ -(lf (Lb gq)-.a ity/State) (Zip) MECHANICAL DESCRIPTION WORKSHEET/FEE SCHEDULE NUMBER X EACH OF UNITS UNIT DUCTWORK SYSTEM T++ ORSTOVE/INSERT AS:WATER HEATER :HEATING EQUIPMENT <100,000 TING EQUIPMENT +100,000 A'S PIPING (EA OUTLET) IG:1-100M BTU (NOT A/C ,101-500M.BTU REFRIG..:501-1,000M BTU • PRIG`.1,001-1,750M BTU :G+1,750M BTU HEAT.PUMP.&'AIR CONDITIONER TPUMP &'AIR.CONDITIONER ;,PUMP & AIR CONDITIONER ATPUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER VENTILATING. FANS VAPORATIVE.000LERS TYPE'I. HOOD "'' (PER 12 ' OR 1 BTU BTU OR HEAT PUMP) QTY„PEII . HOOD 0-3 TONS _ 3-15 TONS 15-30 TONS 30-50 TONS +50 TONS ' PTN. OF. HOOD) CLOTHES' `DRYER 4NGE [ISCELLANEOUS .(NOT COVERED ELSEWHERE) NL'ISTED GAS APPLIANCE <400,000 BTU UNLISTED'GASAPPLIANCE >400,000 BTU USED;APPLIANCE.<400,000 BTU SEDIAPPLIANCE;>400,000 BTU IkHANDLER <1O,000 CFM AIR HANDLER >10,000 CFM FEF IS$35.00 = 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 16.00 = x;/50.00 = x100.00 = (�x 50.00 = x100.00 = x 12.00 = x 15.00 = SUBTOTAL PLUS: PROCESSING FEE 12,00 + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ •CU Spokane County Department of Buildinp and Safety est 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675