Loading...
1991, 01-18 Permit App: 91000191 Furnace, PipingMECHANICAL PlWMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS : . � �(, /4 O ✓(9 CITY/STATE/ZIP: a r,Q ('2 PARCEL NUMBER: OWNER: (/ L QcAj � ,D %/' N 'Nc' -& 4 PHONE NUMBER: MAILING ADDRESS: (Street) (City/State) . (Zip) CONTRACTOR:_© 0 -CA A. LICENSE NUMBER: l- /4 13(, r6 / PHONE NUMBER: YG 7- yo MAILING ADDRESS: �• 0}c (0 & -w ", /'/" . �T'9 8'll (street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION OFFUUNNIITTS EACH I AMOUNT DUCTWORK SYSTEM - - _ _ _ _ _ _ WOODSTO-JE/INSERT GAS WATER HEATER- - -_ Riff HEATING. EQUIPMENT <2070,-500 BTO HEATING -EQUIPMENT .41008000 ;BTU GAS. PIPING..ti(Ek.OUTLET) REFRIG.--;1-�100M.PTU-,(NOT A/C OR : HEAT PUMP) REFRIG 101-500M :BTU REFRIG REFRIG .1, 001=1 750M; BTU_ REFRIG -;+1, 750M BTU _ _ _ _ - _ HEAT PUMP & =`AIR`` -CONDITIONER � 0 -3 -`LIONS _ HEAT -PUMP & AIWCONDITIONER 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 121 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 <16,000 CFM _ _ _ _ _ _ _ _ AIR HANDLER >10,000 CFM _ - _ _ - _ _ _ SUBTOTAL PLUS: PROCESSING FEES+ $ 25.00 EQUALS: TOTAL PERMIT NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE _ $ SIGNATURE Spokane County Department of Building and Safety West 1303 Broadwav Avenue Spokane, WA 9260 (509) 456-3675 •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 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 = xs .. SUBTOTAL PLUS: PROCESSING FEES+ $ 25.00 EQUALS: TOTAL PERMIT NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE _ $ SIGNATURE Spokane County Department of Building and Safety West 1303 Broadwav Avenue Spokane, WA 9260 (509) 456-3675