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1989, 08-30 Permit: 89003085 MechanicalMECHANICAL PERMIT APPLICATION FORM Information Worksheet �Cx JOB STREET ADDRESS: CITY/STATE/ZIP �,PARCEL NUMBER: OWNER: PHONE NUMBER. C���. ' ao( l MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR :_'\ � �r LICENSE NUMBER - PHONE � PHONE NUMBER :� MAILING ADDRESS: \� ��� ��\U��\V 21 (Street) (Ci y/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION NTjMBER OF UNITS ! X EACH I UNIT = AMOUNT DUCTWORK SYSTEM_ _ _ _ _ _ _ _ _ _ _ _ _ WOODSTOVE/INSERT _ _ _ _ _ _ _ _ _ _ _ _ GAS WATER HEATER _ _ _ _ _ _ _ _ _ _ _ _ HEATING EQUIPMENT <100,000 BTU _ _ _ _ _ HEATING EQUIPMENT +100,000 BTU _ _ _ _ _ GAS PIPING (1 - 4 OUTLETS) _ _ _ _ _ _ _ GAS PIVING (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 = 1x 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 = SUBTOTAL $ PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE _ $-�C•W SIGNATURE Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675