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1990, 11-09 Permit App: 90006056 Furnace, Piping
MECHANICAL PERMIT APPLWATION InformationWor--ke eet JOB STREET ADDRESS: SSD 1 C 3 g. /17.'/ e.� CITY/STATE/ZIP: P4 t RFU' 6 I7:. PARCEL NUMBER:` 501/42- OWNER: 4 CO St)///1//?.A./ Q MAILING ADDRESS: l e/ (v i 44004( .AP' (Street) BER: 45_ (City/state) (Zip) CONTRACTOR: A)D T rI e g I J EA R 7 /LICENSE NUMBER: ,,,J d/?r_ £ / /Jam' 3 r PHONE NUMBER: / / f /; 5 o,E!AAi 1.4).41, 97. d (City/Stater (Zip) MAILING ADDRESS: (Street) CHANICAL.WORKSHEET/FEE SCHEDULE NUMBER X EACH OF UNITS tTNIT 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/t OR HEAT REFRIG 101-500M BTU REFRIG 501-11000M BTU- REFRIG 1,001-1,750M BTU:_ . REFRIG +1,750M BTU _ _ HEAT PUMP & AIR CONDITIONER 0-3 TONS HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER VENTILATING FANS _ _ EVAPORATIVE COOLERS TYPE`I HOOD (PER 12' TYPE II HOOD_ _ CLOTHES DRYER RANGE GAS LOG________________ MISCELLANEOUS (NOT COVERED:ELSEt�WHERE)_ UNLISTED GAS APPLIANCE <400,000 BTU' UNLISTED GAS APPLIANCE >400,000 BTU USED APPLIANCE <400,000 BTU USED APPLIANCE >400,000 BTI: AIR HANDLER <10,000 CFM AIR HANDLER >10,000 CFM 3-15 TONS 15-30 TONS 30-50 TONS +50 TONS OR 12' PTN. OF;, HOOD) .111111. x$?0.00 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 = 10.00 = 10.00 50.00 10-.00 =n 10.00 = 10.00 = 10.00 = x 10,00 = x 50.00 = x100.00 = x 50.00 = x100.00 x 12.00.= x 15.00 = x AMOUNT ©tom / aQ NOTE: MINIMUM PERMIV FEE IS"`$35.00 SIGNATURE SUBTOTAL $ /3, co' Spokane Department West 1303 Brea a� venue Spo PLUS: PROCESSING FEE 25.00 EQU : TOTAL -PERMIT FEE DUE Bultdin and Safel ' = 0 (559) 456-3675 - $ Ser. o d