1994, 07-08 Permit App: 94006329 Heat Pump, ACMECHANICAL PERMIT`APPL"ICATION FORM
Information Worksheet
JOB STREET ADDRESS: AI x A cg
CITY/STATE/ZIP: S /J ?_n,in, Ua 77-O n G. PARCEL NUMBER:
OWNER:
MAILING A'DRESS:
(City/State) (Zip)
LICENSE NUMBER: /VI ,PrQ WA -671 4_/-� PHONE NUMBER:
MAILING ADDRESS: .E A 1 p 7 / rr.e
(Street)
PHONE NUMBER: 1Z)-79 7i ---
et)
CONTRACTOR: .),ryY9 .40-4±-6
ity/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS EQUIPMENT <100,000 BTU (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 101-500M BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,0001-1,750M BTU
BOILER/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
VENTILATING FANS
EVAPORATIVE' COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE .IIHOOD
CLOTHES DRYER
RANGE:'>.
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED 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
(Zip)
NUMBER
OF UNITS,
X EACH
UNIT
= 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 35.00 =
x 35.00 =
x 60.00 =
x12.00 =
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 50.1)0 =
x1000=
x 50..00 =
x100.00 =
x 12.00 =
x 15.00 =
-
)r) Q(.5
SUBTOTAL
$ /3.n o
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
-4_32,00
Spokane County Division of Buildings
West 131 'way Avenue Spokane, WA 99260 (509) 456-3675