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1990, 08-24 Permit App: 900004183 Furnace Piping
MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: CITY/STATE/ZIP: S?OK/?NF 1 wN • Y92o(- PARCEL NUMBER: OWNER: D bLd" , 2fi , - PHONE NUMBER: MAILING ADDRESS: S • SD �j (Street). (City/State) (Zip) CONTRACTOR:,2SoiU 5 91/6E% f'j!E%/iL LICENSE NUMBER: fiNDEesM /S 8N 7 - PHONE PHONE NUMBER: 2?- O 9.6 a MAILING ADDRESS: E. /3903 7-,e9-1tI7- fiVE I 5-t`6k,�In/C, w�U' 9�a1 L (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION I OF UNITS I UNIT = AMOUNT 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 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 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 _ _ _ _ _ _ _ x$10.00 _I 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. OC = 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 = SUBTOTAL 1 $ /3 • rD PLUS: PROCESSING FEEI+ $ 25.00 EQUALS: TOTAL PERMIT NOTE: MINIMUM PERMIT FEE IS $35.1001 FELE DUE _ $ 3R -- SIGNATURE R--SIGNATURE„y✓L- { 6 a Spokane County Department of Building and Safety West 1303 Broadwav Avenue Spokane, WA 99260 (509) 456-3675 i'I, SUBTOTAL 1 $ /3 • rD PLUS: PROCESSING FEEI+ $ 25.00 EQUALS: TOTAL PERMIT NOTE: MINIMUM PERMIT FEE IS $35.1001 FELE DUE _ $ 3R -- SIGNATURE R--SIGNATURE„y✓L- { 6 a Spokane County Department of Building and Safety West 1303 Broadwav Avenue Spokane, WA 99260 (509) 456-3675 i'I,