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1990, 11-26 Permit App: 90006381 Furnace MECHANICAL PERMIT APPLICATION FORM 0471g'-3 Information Worksheet JOB STREET ADDRESS: S , I,5Q,`_ .7)A Ut i CITY/STATE/ZIP: \JOf4A I'L.. i t,dtj PARCEL NUMBER: ka (bU , ,_..141- c e*°t,o PHONE NUMBER: / ,e- OWNER: ." - * MAILING ADDRESS: S. / 3oc 7 / h/5os ( \jiCyfttle Viet (Street) (City/State) (Zip) CONTRACTOR: (2(0,4, /t,_6_, LICENSE NUMBER: PHONE NUMBER: MAILING ADDRESS: (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT = AMOUNT DUCTWORK SYSTEM x$10. 00 = WOODSTOVE/INSERT x 25. 00 = GAS WATER HEATER x 10. 00 = HEATING EQUIPMENT <100, 000 BTU j x 12 . 00 = 12 2 HEATING EQUIPMENT +100, 000 BTU x 15. 00 = GAS PIPING (EA OUTLET) x 1.00 = I n-`' REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12. 00 = REFRIG 101-500M BTU x 20. 00 = REFRIG 501-1, 000M BTU x 25. 00 = REFRIG 1, 001-1,750M BTU x 35. 00 = REFRIG +1,750M BTU x 60.00 = HEAT PUMP & AIR CONDITIONER 0-3 TONS _ _ x 12 . 00 = HEAT PUMP & AIR CONDITIONER 3-15 TONS _ x 20. 00 = HEAT PUMP & AIR CONDITIONER 15-30 TONS _ x 25. 00 = HEAT PUMP & AIR CONDITIONER 30-50 TONS _ _ x 35. 00 = HEAT PUMP & AIR CONDITIONER +50 TONS _ _ x 60. 00 = VENTILATING FANS x 10. 00 = EVAPORATIVE COOLERS x 10. 00 = TYPE I HOOD (PER 12 ' OR 12 ' PTH. OF. HOOD) x 50. 00 = TYPE II HOOD x 10. 00 = CLOTHES DRYER x 10. 00 = RANGE x 10. 00 = GAS LOG x 10. 00 = MISCELLANEOUS (NOT COVERED ELSEWHERE) _ x 10. 00 = UNLISTED GAS APPLIANCE <400, 000 BTU _ _ x 50. 00 = UNLISTED GAS APPLIANCE >400, 000 BTU_ _ _ x100. 00 = USED APPLIANCE <400, 000 BTU x 50. 00 = USED APPLIANCE >400, 000 BTU x100. 00 = AIR HANDLER <10, 000 CFM x 12 . 00 = AIR HANDLER >10, 000 CFM x 15. 00 = SUBTOTAL $ PLUS: PROCESSING FEE + $ 25. 00 EQUALS : TOTAL PERMIT NOTE: MINIMUM PERMIT FEE IS $35. 00 FEE DUE _ $ SIGNATURE xLrt_ Spo ane County Department of Building_ and Safety West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675