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1989, 10-02 Permit App: 89003711 Heating EquipmentMECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: e-,72,1 CITY/STATE/ZIP: Sy g 2,,., /1,11.... 79a/2. PARCEL NU! ER: 0405--4/e-E?1 Z -- OWNER: Ca„ itz, MAILING ADDRESS: f. '7f1/ }e4.2 (Street) PHONE NUMBER: 9a a - /r7 7 CONTRACTOR: fiNQERSe.J's SMEcrr mETfK- MAILING ADDRESS: . /3r0.3 7:144,21" (Street) En...,,� cJ,r, . 9 fa% (City/State) (Zip) LICENSE NUMBER: Ant Die sty) /8sN z - PHONE NUMBER: 9a/ - 0 76v (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH OF UNITS UNIT DESCRIPTION = AMOUNT DUCTWORK SYSTEM WOODSTOVE/INSERT GAS WATER HEATER HEATING EQUIPMENT <100,000 BTU HEATING EQUIPMENT +100,000 BTU GAS PIING (5 OR MORE. EACH:) 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 & HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & VENTILATING 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 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 x$10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x . 1.00 - 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 = , ao SUBTOTAL $ 1a ao PLUS: PROCESSING FEE + $ 25.00 NOTE: MINIMUM PERM T FEE I8 $35.00 SIGNATURE` Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 EQUALS: TOTAL PERMIT FEE DUE = $ 37.+0 Ck 41975