1990, 10-24 Permit App: 90005634 Wood StoveJOB STREET ADDRESS:
4 '
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
.6/.5 LUG '/XC CU
CITY/STATE/ZIP: .S://�(j(J( /t4 .'qZI0PARCEL NUMBER:
OWNER:�tf/1) C.�� ,( /4&vL IIJ
MAILING ADDRESS: /y 6-46 LLIG,//G'
CONTRACTOR:
(Street)
3.61+N qt
PHONE NUMBER: iW -6735
44,E GJ4 • 9lZ/�
(City/State) (Zip)
LICENSE NUMBER:
PHONE NUMBER: 9-162-62-a5
MAILING ADDRESS: N 5('c5 LucH/E R.o Spc i e, LAi . 9'C21SO
(City/State) (Zip)
(Street)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS ITNIT
DESCRIPTION
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (EA OUTLET)
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
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
0-3 TONS,
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
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
/
= 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 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 =
NOTE:
SIGNATCJR
Spokane Coun
West 1303 Broadwav
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Department of Building and Safety
venue Spokane, WA 99260 (509) 456-3675