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1990, 03-13 Permit App: 90000855 Furnace, PipingMECHANICAL PERMIT Information JOB STREET ADDRESS: CITY/STATE/ZIP:t�d U�Uj cl::z OWNER: �.d�� 0 MAILING ADDRESS; ,ria -r (Street) CONTRACTOR: a -le 1q ` MAILING ADDRESS: l0 0 0 a A/Al MAILING (Street) APPLICATION FORM Worksheet (c!La � PARCELNUMBER: PHONE NUMBER; (City/State) (,zip) LICENSE NUMBER: ICS PHONE OBER: 75- GVcw (City/State) (zip) MECHANICAL 'WORKSHEET/FEE DESCRIPTION SCHEDULE NUMBER OF UNITS X EACH 17NIT _ AMOUNT 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 1,001-1,7�OM 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 &,ATR CONDITIONER +50 TONS VENTILATING FANS - - EVAPORATIVE,COOLERS _ _ - _ - TYPE I HOOD (PER 120 OR 12'-PTN. OF -HOOD) TYPE II HOODx 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 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 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 EQUALS: TOTAL PERMIT NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE SIGNATURE Spokane County Department of BuIldin��q and Safety West 1303 Broadwav Avenue Spokane, WA 99260 (509) $ + $ 25.00 _ $ 456-3675