Loading...
HomeMy WebLinkAbout1991, 08-13 Permit App: 91004985 Furnace, PipingJOB STREET ADDRESS: MECHANICAL PERMIT APPLICATION FORM Information Worksheet 664 ,U4'ii,a4z& tWd5 FILE. CITY/STATE/ZIP: � 'V,i 9V/2PARCEL NUMBER: q nn OWNER: 4-t J 4ze. PHONE NUMBER: -02 'SO MAILING ADDRESS: CONTRACTOR: (Street) MAILING ADDRESS: (City/State) (Zip) LICENSE NUMBER: AMQUA1IR19 iN1 PHONE NUMBER: 928-2100. (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 GAS PIPING (EA OUTLET) REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) REFRIG 101-500M BTU 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' TYPE II HOOD CLOTHES DRYER PTN. OF HOOD) 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 = /A.00 I, 00 NOTE• NI UM P ,i!.j FEE ; S 35.00 i4.SIGNATU/ SUBTOTAL $ 13.00 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ 3g,00 S i okane County Department of Building and Safety West 13 i 3 Broadway Avenue Spokane, WA 9260 (509) 456-3675 MECHANICAL PERMIT APPLICATION FORM Informationn Worksheet A Q JOB STREET ADDRESS: E. i' 1Oaq- L e,f o,�ftV& CITY/STATE ZIP: 5 (0/4 /tie) OA, ?t7 /J. PARCEL NUMBER: OWNER: A ALO © (_Se!V MAILING ADDRESS': CONTRACTOR: PHONE NUMBER: Sreet) (City/State) (Zip) LICENSE NUMBER: AMQUAHE193N1 PHONE NUMBER: 928-2100 MAILING ADDRESS: (City/State) (Street) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UTNIT DUCTWORK SYSTEM WOODSTOVE/INSERT GAS WATER HEATER HEATING EQUIPMENT <100,000 BTU _ HEATING EQUIPMENT +100,000 BTU GAS PIPING (EA OUTLET) _ y1512/1)_4 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 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 = AMOUNT x$?0.00 = 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 = NOTE: NI UM PE T FEE IS $35.00 SIGNATURE SUBTOTAL $ PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ Spokane County Department of Building_ and Safety West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675