Loading...
1991, 11-13 Permit App: 91007801 Re-line ChimneyMECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: / 30 (c:1, - CITY/STATE/ZIP: S to-ean e/ &✓+1/ /qZ/-d PARCEL NUMBER: 1 5 OWNER: (/R'A'owni 'Rh( Afeirdy -graZ7` PHONENUMBER: 1/ MAILING ADDRESS: S• ,.-.r/5 " /so STel"5 SPokan€. GJ q q/ 9 2-0C dim- �, // (Street) CONTRACTOR: dim- CA -ter --e < MAILING ADDRESS: /1 ZSa V 4-444nJ7 c. (Street) DESCRIPTION (City/State)�pp (Zip) LICENSE NUMBER: CsdiMC E4,7z L 7 PHONE NUMBER: 3u - 24/g .S/'o ea -41e_ Gt/ /4- j ?21557L (Zip) ". 2 (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE 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 1,0001-4,750M BTU__ BOILER/REFRIG +1,750M BTU HEAT,PUMP_-S4 CONDITIONER94.TONS,.__ _ :..:. HEAT PUMP & AIR CONDITIONER 3-15 TONS HEATPUMP &AIR CONDITIONER'15-30 TONS _ HEAT PUMP & AIR CONDITIONER 30-50 TONS HEATPUMP:& AIR CONDITIONER+50 TONS ..: ::. .::.:... ' VENTILATING FANS EVAPORATIVE COOLERS., ., ..._ TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) CLOTHES DRYER GAS LOG MISCELLANEOUS'(NOTCOVERED ELSEWHERE:;- UNLISTED GAS APPLIANCE <400,000 BTU ULINSTED GAS'APPLIANCE BTU USED APPLIANCE <400,000 BTU USED APPLIANCE>400,000 STU AIR HANDLER <10,000 CFM AIR,HANDLER'>10;000 CFM::::'." NOTE: MINIMUM PERMIT FEE IS $35.00 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 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 = SUBTOTAL $ PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675