1990, 07-03 Permit App: 90003123 Mechanical FixturesJOB STREET ADORE
CITY/S'qATE/ZIP
OWNER:
MECHANICAL PERMIT APPLICATION FORM
Information Wrksheet
9
/1P1oP
PARCEL NUMBER:
PHONE NUMBE
MAILING AD
CONTRACTOR:'.
MAILING ADDRESS:
(Street)
�/ /-0(< %
(City/State) (Zip)
LICENSE NUMBER: Se--5.c_-*/702.1(T
PHONE NUMBE': 7 -//%D % 5
hJa 99C
City/State' (Zip)
MECHANICAL
DESCRIPTION
WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
= AMOUNT.
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <igo;000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS;PIPING (1 - 4 OUTLETS)
GAS:PI$ING (5' OR -MORE. EACH:)
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 FOOD .(PER .12' OR 11' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT,. COVEREDIELSEWHERE)
UNLISTED`GAS-APPLIANCE<400;000 BTU
UNLISTED•GAS APPLIANCE`>400,000 BTU
USED APPLIANCE.<400,000BTU
USED APPLIANCE >400,000.BTU.':
AIR HANDLER <10, 000" CFMf
AIR HANDLER >l0,000
/
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 1,.29 _
x 4-.-08
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.=
x160.00.=
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/4o
/6
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
+•$ ' 25.00
EQUALS: TOTAL PERMIT
FEE=DUE
= $ 87
Spokane 'County Department 'or Buildin-g and:.Safety
West 1303 Broadway Avenue..Spokane; WA 99260 (509) 456-3675