Loading...
1989, 11-20 Permit App: 89004824 Furnace, PipingMECIIAMCAL PERMIT APPLICATION FORM Information Worksheet • yycs2N JOB STREET ADDRESS: 5'0 hill 7 cIfus t t,,y-► `ce CITY/STATE/ZIP: ` rh , fry e PARCEL NUMBER: PHONE NUMBER: 9-),Zg VO53 OWNER: MAILING ADDRESS: /4 5. - -t (Street) CONTRACTOR: MAILING ADDRESS: r - t o '2- A/ p ✓L } (Street) MECHANIC DESCRIPTION (Citg/State) (Zip) LICENSE NUMBER:4 unset PHONE NUMBER: 3 '4? (City/State) WORKSHEET/FEE SCHEDULE. NUMBER X EACH OP UNITS ITNIT 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 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 99.2, 47 (Zip) = 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 • 25.00 = • 35.00 = • 60.00 • 12.00 = • 20.00 = • 25.00 • 35.00- • 60.00 • 10.00 • 10.00 • 50.00 • 10.00 • 10.00 = • 10.00 = x 10.00 = x 10.00 = x 50.00 x100.00 x 50.00 = x100.00 = x:12.00 = x 15.00 = jaw r d! SUBTOTAL PLUS: PROCESSING FEE EQUALS: TOTAL PERMIT FEE DUE Qepertinent of Buiidin venue Saolciiiie,.WA and Safety 260 (509) 456-3675