HomeMy WebLinkAbout1990, 10-15 Permit App: 90005396 Gas Log, PipingMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: Z •1-IUf fnco<L,JitiI
CITY/STATE/ZIP:5th L A9c1)-1)-' PARCEL NUMBER:
OWNER:Shqu:,�ihov( 1p�ck) I CX-4.k11/4;in PHONE NUMBER: °�Zc{-.LI-Ii�
5
MAILING ADDRESS: Z_.1 )c 4 / loO c Q\\ Spo
(Street) (City/State)
CONTRACTOR: Sai LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(Street)
(Zip)
(City/State) (Zip)
MECHANICAL
DESCRIPTION
WORKSHEET/FEE SCHEDULE •
NUMBER - X EACH
OF -UNITS UNIT.
DUCTWORK. SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING,EQUIPMENT <100,0- 00 - BTU._
HEATING EQUIPMENT +100,000 BTU` --a_'
GAS PIPING (EA -OUTLET) _,
REFRIG'1-100M BTU (NOT A/- C_- OR HEAT PUMP),;
REFRIG 1017500M BTU •
REFRIG 501-1,.000M BTU':';
REFRIG -1.001-1,750M BTU_;y
REFRIG.,+1,750M BTU
•
HEAT-PUMP"'&"AIR. CONDITIONER
HEAT:PUMP &FAIR CONDITIONERO•
HEAT PUMP &;.AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
VENTILATING FANS
0'=3t`TONS
3-15,4TONS
153Q,u,TONS,
30=50; TONS'
+50.:.TONS
EVAPORATIVE COOLERS
TYPE I HOOD _(PER 12' OR 12'
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
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
' 4
x$10.00 =
x;25.00 =
x''10.00 =
x 12`:00 =
x/15:00._
x.,;1:00 ._
X u 12-. 00
x 2.0.00.=
x-25:00'=
x;35, 00
x(i 60:00: _
x412 : O C . _,
xt 20�: 00'-;-
ic2 5;: 0 0:v;=
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 =
='AMOUNT
tt
•
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675