1989, 12-27 Permit App: 89005342 Furnace, PipingMECHANICAL PERMIT -APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: // Tint Ir'i(14
fof
CITY/STATE/ZIP:372DSPL,.O. GUI . 7 !+x"PARCEL
OWNER: % cd.. + `t./)
MAILING ADDRESS:
NUMBER: f15'1/ -
♦'i
PHONE NUMBER: e0-41 ` 9-C/ LI•
(Street)
i ' c.pr,•n "tom
CONTRACTOR: a QL!.''_1�'1 F ''.ii.n9, (.,�,.
E. 12710 Indiana
Spo' ane, Washington 9216
MAILING ADDRESS:
(City/State)'/ (Zip)
A
LICENSE NUMBER: A' (4144 C (43 A))
PHONE NUMBER: 9(vdl-0 - ia-( 0 Q
(Street)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
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'
TYPE II HOOD
OR 12'
PTN. OF 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
/,;J .0
/cti)
NOTE:INIM
SIGNATURE O'
M 'ERM j FEE IS $35.00
I ►, /
SUBTOTAL
$ ('3.00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 38', 027
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675