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1989, 12-13 Permit App: 89005192 Furnace, PipingMECHANICAL PERMIT,'APPLICATION FORM Information Worksheet` JOB STREET ADDRESS: - 4z CITY/STATE/ZIP: OWNER: MAILING ADDRESS: PARCEL NUMBER: PHONE NUMBER: (street) CONTRACTOR:l-1 Gr�v �l s ��I^ic'_ /���,�� LICENSE (City/State) (Zip) NUMBER: �1 C h� qr 14 /w4 PHONE NUMBER: 3 / MAILING ADDRESS: '�O/ l '5- e:? "5 � P .��o ��4 57 7 ")a 5 - (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT = AMOUNT X$10.00 = 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 & AIR CONDITIONER 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 COOLERS__ _ _ _ _ O TYPE I HOOD (PER 12' R 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 _ _ _ _ - - - - 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 = I m' j Q SUBTOTAL $ I ®@@ PLUS: PROCESSING FEES+ $ 25.00 (EQUALS: TOTAL PERMIT o0 NOTE: MI M M PERMIT FEE IS $35.00 L FEE DUE _ $ g SIGNATURE Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675