1990, 07-30 Permit App: 90003600 AC, Air HandlerMECHANICAL PERMIT APPLICATION
CITY OF SPOKANE
PROPERTY DEVELOPMENT SERVICES
Skywalk Level, Municipal Building
W. 808 Spokane Falls Boulevard
Spokane, Washington 99201-3325
(509)456-3240
JOB ADDRESS„ogie /cscP // e9/51 --X-77-/-61/0
EXISTING PROJECT NO. for this address if known:
OWNER last F/9'/e�e/� firs m
Ai y
CONTRACTOR y
ADDRESS
zi• /G S. �6 =/
4t4Zk 2 - %/T -S-.
CIT
d /.l97cJC
ST
uif
ZIP
,,a,,A
PHONE
5-3 S- a s a-?
LICEN E NUMBER
4--e g cc ie,gl4 /o2SJ 0
CONTACT PERSON
ARCH/ENGINEER
ADDRESS
CITY
ST
ZIP
PHONE
DESCRIBE WORK
MECHANICAL WORK INFORMATION
NEW BUILDING, ADDITION, or REMODEL
RES ENTIAL/ or_, OCIAL
-est
Fans
/
Evap Coolers
Hoods
Furnaces
Ducts
Gas Dryers Gas Ranges
Gas Logs
Wood Stoves
Gas Water Heater
AIR HANDLING: 10,000 CFM or less
More Than 10,000 CFM
REFRIG SYSTEM BTU: 1-100M y0 -,,,,,---1-00-500M
1000-1750M Other
500-1000M
PV (cu ft)
COMPRESSOR HP: Less Th n 3
3-15
15-30
130-50
50+
HEATING SYSTEM: 1-100,000 BTU
100,000+
BTU
GAS PIPING OUTLETS:
FUEL SOURCE:
JOB STREET ADDRESS:
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
CITY/STATE/ZIP:
OWNER:
PARCEL NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(Street)
CONTRACTOR:
MAILING ADDRESS:
(City/State)
LICENSE NUMBER:
PHONE NUMBER:
(Street)
(Zip)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS tUNIT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (EA OUTLET)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
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
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
0-3 TONS _
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE)_ _
UNLISTED GAS APPLIANCE <400,000 BTU_ _ _
UNLISTED GAS APPLIANCE >400,000 BTU_ _
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >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
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675