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1990, 08-06 Permit App: 90003775 Mechanical FixturesMECHANICAL PERIV*T. tia,PLICATION FORM C /Information Worksheet/ JOB STREET ADDRESS: - / > .3 r ,c.�/iOr7} CITY/STATE/ZIP:.$$()tSp#-- PARCEL NUMBER: OWNER: 90 $) L' U.C%/Z f t PHONE NUMBER:} 79,- 3/12 / ,�,2 6 MAILING ADDRESS: E- 1/8'93 -- �,&r)f.4 ,5724/,9/ik e...%/3 - (Street)/(City/State) (Zip) CONTRACTOR:'✓/; % S H7 4 ;f 0/4)(17( LICENSE NUMBER:.r/� MS/lfSI3IQ Nei j� l PHONE NUMBER: /-/tcY 7- 9 67, Q MAILING ADDRESS: C- ` 71// J ()cDQ,/S if� Q1 l-/ luyl / pAryW/J 7 96/ (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH OF UNITS UNIT DESCRIPTION = AMOUNT DUCTWORK SYSTEM WOODSTOVE/INSERT GAS WATER HEATER HEATING EQUIPMENT <100,000 BTU HEATING EQUIPMENT +100,000 BTU GAS PIPING (1 - 4 OUTLETS) GAS PIING (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 & AIR CONDITIONER 0-3 TONS HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT PUMP & AIR CONDITIONER 15-30 TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMP & AIR CONDITIONER +50 TONS VENTILATING FANS EVAPORATIVE COOLERS TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE II HOOD 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 x$10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x 4.00 = x 1.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 12.00 = x 20.00 = 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 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = Id -00 1 . GC' 1 NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE SUBTOTAL PLUS: PROCESSING FEE $ 95' + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE 312 Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675