1990, 11-09 Permit App: 90006065 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Inform on Workshee/
STREET ADDRESS �i �(2V,
1L!
JOB ../�
CITY/STATE/ZIP • Q,K t 6/4 L,/U C PARCEL NUMBER:
OWNER: L'Pt 064/Y
61 % PHONE NUMBER:
MAILING ADDRESS:
6-it
(Street)
CONTRACTOR: (
MAILING ADDRESS: E-70 XS
(Street)
(City/State
LICENSE NUMBER:
• PHONE NUMB
VL(L
(Zip) 1
Ci y/Stat'e)
MECHANICAL WORKSHEET/FEE SCHEDULE /
NUMBER Y ,,EEACH
OF UNITS , i?NIT
DESCRIPTION
(Zip
= 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
0-3 TONS
3-15 TONS
15-30 TONS _
30-50 TONS _
+50 TONS
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP. & AIR CONDITIONER
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
$10.00
x 25.00
x 10.00
x 12.00
x 15.00
x 4.00
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
SUBTOTAL (
lav)
,x)
$ W
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 63 Co
NOTE: (MI.IMUM T F IS $35.00
YiL1 11i/W-4/--
Spokane
ounty Department of Building and Safety
West 1303 Broa way Avenue Spokane, WA 99260 (509) 456-3675