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1990, 09-10 Permit App: 900047473 ChimneyJOB STREET ADDRESS: CITY/STATE/ZIP: S /6)0(Z ---1)%/i.)111-- ggML PARCEL NUMBER: OWNER: '1_1/44( ; rtYt fr - ( MAILING ADDRESS: (Street) MECHANICAL PERMM A'LICATION FORM Information Worksheet PHONE NUMBER: ( s-6 5-5) (City/State) (Zip) CONTRACTOR: A 1/001 C-ff / 9/L' /1,33 g0,, LICENSE NUMBER: !/l% 7%0CS /©DSL PHONE NUMBER: 97Z-ZO (City/State) (Zip) MAILING ADDRESS: MECHANICAL WORKSHEE/FEE SCHEDULE NUMBER:; X EACH OF UNITS tTNIT .: DUCTWORK`,SYSTEM-' . WOODSTOVE/INSERT, _ GAS WATER,,; HEATER _ HEATING. EQUIPMENT <100,000,W HEATING EQUIPMENT +100,000{' • GAS:„, PIPINGiaEA ;.OUTLET) ;� , REFRIG 110.0M ,BTU , (NOT .'.A 'REFRIG.1.0,lip00M BTU b REFRIG 501-1,000M BTU .' REFR'IG x 1, 001 1, 750M . BTU .' REFRIG -+I, 750M BTU ,f HEAT PUMP `,&7':AIR,t-CONDITIONE HEAT' PUMP &AIR ' CONDITIONER, 3 1 . HEAT ;PUMP 1. & ,AIRS,' CONDITIONER ' 1543 HEAT PUMP.':&i; AIR :CONDITIONERi 30-50 VENTI'LIAw'TING;'kr.;FANSHEAT,PUMP&AIRCOND'ITION. O' N0, S EVAPORATIVECOOLRS ,TYPEHOOD:PER 12_ OR et TYPE,, II ; HOOD CLOTHES °” DRYERS• RANGE GAS LOG MISCELLANEOUS (NOT COVERED` ELSEWHERE UNLISTED GAS APPLIANCE :<400,000_BTU i`. 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 NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE SUBTOTAL 10.00 x 50.00 x100,00 x'50:00 '= x100.00 x 12.00 = x 15.00 = PLUS: PROCESSING FEE + S 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ ,5 -e) -`v Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675