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1989, 07-10 Permit App: 89002058 Furnace, PipingMECHANICAL PEn- MIT_ APPLICATION FORM Informat"o'n�Worksheet JOB STREET ADDRESS: CITY/STATE/ZIP: PARCEL NUMBER: %W6//3 -- V'ZUU'7 1 OWNER: G ���y x I �� PHONE NUMBER: MAILING ADDRESS: /_ (Street) (City/State) (Zip) CONTRACTOR: LICENSE NUMBER: �a PHONE NUMBER: MAILING ADDRESS: Z /c a- xt c _ ! - S iJI % (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT = AMOUNT DUCTWORK SYSTEM_ _ _ _ _ _ _ _ _ _ _ _ _ WOODSTOVE/INSERT - - _ - - - _ _ _ _'_ _ GAS WATER HEATER _ _ _ _ _ _ _ _ _ _ _ _ HEATING EQUIPMENT <100,000 BTU _ _ _ '_ _ HEATING EQUIPMENT +100,000 BTU _ _ _ _ _ GAS PIPING (1 - 4 OUTLETS) _ _ _ _ _ GAS PIING (5 OR MORE. EACH:)_ _ _ _ _ _ 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 _ _ _ TYPE T HOOD (PER 1L_ OR 12', PTN. o HOOD) TYPE II HOOD _ CLOTHES DRYER RANGE GAS LOG_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ NEO MISCELLAUS (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�s'j��- x$10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x /t,.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 70. UO = x 10.00 = x 10.00 = x 10.00 = x 19.00 = x 10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = �a _ ! - S iJI SUBTOTAL $'` �J PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT NOTE: MINIMUM PERMIT FEE IS $35.100 FEE DUE SIGNATURE Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675