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HomeMy WebLinkAbout1995, 05-02 Permit App: 95002857 Furnace, Piping35 13 2- ci 04-) MECHANICALPERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: _S , C CITY/STATE/ZIP: .--1)(')1_ jc/UA- 9'qZi? PARCEL NUMBER: OWNER: PL MAILING ADDRESS: 615 zgs7 PHONE NUMBER: 35 9 Li (Street) (City/State) (Zip) CONTRACTOR: /1/1/9-TP.W/17._ LICENSE NUMBER: 414-1 O(3/E2(f) PHONE NUMBER: MAILING ADDRESS: 57 b 67.4;idnati (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOVEIINSERT GAS WATER HEATER GAS EQUIPMENT yo00,o00p,T:viliNp(0 GAS EQUIPMENT +100,000 BTU DUCTWORK) dA$;ppiooikoKOOTC:••: BOILER/REFRIG 1-100M BTU BOILER/REFRIG. 101-500M BTU BOILER/REFRIG 501-1,000M BTU BOILEflIREFRIG 1,000i -1,750M BTU ....................... .. . BOILER/REFRIG +1,750M BTU HEAT PUMP & AIR COND!TIONER 0-3 TONS HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT PUMP &AIR CONDITIONER 15-30 TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMP &AIR CONDITIONER +50 TONS VENTILATING FANS EVAPORATIVE COOLERSTYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPEIIHOOD CLOTHES DRYER RANG. .. .. . • . GAS LOG MISCELLANEOUS (NOT COVERED ELSEWHERE UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED GAS APPLIANCE >400,000 BTU USED APPLIANCE <400,000 BTU USED APPLIANCE >400,000 BTU :•i- AIRHANDLEF<10000C.FM AIR HANDLER >10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE - NUMBER OF UNITS X EACH UNIT = AMOUNT x10,00 = x 25,00 = x10,00 = i x 12.00 = x 15.00 = x1.00 = 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 = x10.00 = x10.00 = x 50.00 = x10.00 = x10.00 = x10.00 = x10.00 = x10.00 = x 50.00 = x100.00 = x 50,00 = x100.00 = x 12.00 = x 15.00 = SUBTOTAL $ C4i, 4° PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =$ Sp kane County Division of Building's West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675