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1991, 10-29 Permit App: 91007273 Furnace, PipingMECHANICAL PERMIT APPLICATION FORM (J/E;&6424dos Information Wexksheet LI/71 /71 JOB STREET ADDRESS: 8515 E, Knox CITY/STATE/ZIP: Spokane; , WA 99212 PARCEL NUMBER: OWNER: Bob Land MAILING ADDRESS: (Street) CONTRACTOR: Allied Heating. Inc. PHONE NUMBER: MAILING ADDRESS: 9309 E. Trent (Street) MECHANICAL DESCRIPTION (City/State) (Zip) LICENSE NUMBER: PHONE NUMBER: ALLIEI*200D4 928-8252 Spokane, WA 99206 (City/State) (Zip) 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 REFRIG 101-500M BTU REFRIG 501-1,000M BTU HEAT PUMP) REFRIG 1,001-1,750M BTU REFRIG +1,750M BTU HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER VENTILATING FANS EVAPORATIVE COOLERS 0-3 TONS _ 3-15 TONS 15-30 TONS 30-50 TONS +50 TONS _ TYPE I HOOD (PER 12' OR 12' TYPE II HOOD CLOTHES DRYER RANGE GAS LOG PTN. OF' HOOD) MISCELLANEOUS (NOT COVERED E UNLISTED GAS APPLIANCE <400, UNLISTED GAS APPLIANCE >400, USED APPLIANCE <400,000 BTU USED APPLIANCE >400,000 BTU AIR HANDLER <10,000 CFM AIR HANDLER >10,000 CFM LS EWHERE) ...t 000 BTU 000 BTU 1 • t. = 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 0 x 50.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x'10.9 _ x 50.d0 = x100.00 = x 50.00 = x100.00 =_ x 12.00 x 15.00 = !a oo ,oa NOTE: MIN SIGNATURE SUBTOTAL PLUS: PROCESSING FEE 17 00 + $ 25.00 EQUALS: TOTAL PERMIT MUM PERMIT FEE I8 $35.00 FEE DUE Spokane County Department of Buildin_�qq and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 = $ 38.00 AciJ iidia;ei i>.uwgt ,.._:«t . ..,,, 9➢(iiri roiaa, hy` 0 =?moi