1990, 07-18 Permit App: 90003374 Mechanical FixutresJOB STREET ADDRESS:
CITY/STATE/ZIP:
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
i93�s-
GtJJ� PARCEL NUMBER:
OWNER: /J a227.--.4
MAILING ADDRESS:
CONTRACTOR:
3� 5
(Street)
PHONE NUMBER:
e? -:7171 -..-LICENSE
PHONE
MAILING ADDRESS': 2'//3"/.2›
, ---G--�
- gy
CeJ, 9- a/6
(City/State) (Zip)
NUMBER: /;;Z /' 17 '- / :/ l)
NUMBER:
(Street)
(City/State), (Zip).
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
H
OF UNITS UNIT
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 •*1707,
REFRIG 1,001-1,750 BTU_
REFRIG +1,750M BTU
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP.. & .
HEAT PUMP &
VENTILATING
EVAPORATIVE
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
0-3 TONS
3-15 TONS
15-30 TONS _
30-50 TONS
+50 TONS
COOLERS
TYPE I HOOD (PER 12'
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS'LOG
OR 12' PTN. OF HOOD)
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 =
m
i
o
`0o
NOTE: MINIMUM`7-11a614-t/
NI[ PERMIT FEE FEE IS $35.00
/ / � 614- ��C
SIGNATURE
SUBTOTAL
$ 2s. oa
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 5')-oa
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675