1990, 05-18 Permit App: 90002198 WoodstoveMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: E 8 ZD 7 G /R S s
CITY/STATE/ZIP: 5/ Tara_ 1/09 992/ ZYARCEL NUMBER:
OWNER: Z7/) .
MAILING ADDRESS:
CONTRACTOR:
PHONE NUMBER: qz 8 5-3 89
(Street)
MAILING'ADDRESS:
(City/State) (Zip)
LICENSE NUMBER:
PHONE NUMBER:
(Street)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
OF UNITS
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000
HEATING EQUIPMENT +100,000`
GAS PIPING :;(EA . OUTLET).
REFRIG..'-1-100M.BTU (NOTA/C,
REFRIG ;101-500M;BTU)`;
REFRIG 501-:1 000M :BTUl�
REFRIG1,001-1,750M=BTU_
REFRIG +1,750M BTU _
HEAT PUMP &- AIR CONDITIONER~
HEAT PUMP, &,: AIR `CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP &:,AIR- CONDITIONER.
HEAT PUMP & AIRCONDITIONER,
VENTILATING, FANS _ _
EVAPORATIVE COOLERS_ 5R -1D _ _
TYPE I HOOD ` (PER ,12' ` OR 12'
TYPE II HOOD
BTU x
B
OR HEAT• PUMP)
0-3 :.;TONS • ' `
.3-15);.TONS
15-30 TONS:
3,0-50 . TONS,
+50 TONS
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
PTN.`: OF. HOOD)
= 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
x25.00
x 35.00
x 60.00
x 10.00
x 10.00
x 50.00
x 10.00
x10.00 =
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
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
NOTE: MI MUM PE IT FEE IS $35.00 FEE DUE = $
r
SIGNATURE f�C-Q
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 9260 (509.) 456-3675