1992, 11-09 Permit App: 92009919 FurnaceMECHANICAL -PERMIT APPLICATION FORM
Information Worksheet
•
JOB STREET ADDRESS: !a0 6- F t2E•')EjICK
CPTY/STATE/ZIP: S9nKR.cE., (JA 99&i PARCEL NUMBER:
OWNER: t\ I M innOTTS
PHONE NUMBER: C} 024 - 3In,2cj
MAILING ADDRESS:
(Street) (City/State) (Zip)
A( ti 1 )--i AT(-cG, uQ. LICENSE NUMBER:
C9 NTRACTOR :
M1tILING ADDRESS: 9 E 7? )
(Street)
PHONE NUMBER:
Q azFs -B-�Sa
S?{)K.A-UC, 6, l 59.,,ON
(City/State) (Zip)
MECHANICAL
DESCRIPTION
WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
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
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RNNGE
GikS 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 =
/, 00
NOTE:
MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
$ /3.o0
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Department of Building_ and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675