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