Loading...
1989, 08-11 Permit App: 89002750 Furnace, PipingMECHANICAL PQM Information Worksheet B JOB STREET ADDRESS: 1D j - . CITY/STATE/ZIP: 194 I'StD - `i_kt - P CEL NUMBER: �� -- 3U j OWNER: APPLICATION FORM U� Ate. MAILING ADDRESS: ID (Street) CONTRACTOR: - L J) /I' ,i LICENSE PHONE PHONE NUMBER: MAILING ADDRESS: r 4 -Pa . 3`70-7 0-37°V 6ck ggzz) y/State) (Zip) Ayr- -37a f - (Ci NUMBER: NUMBER: (Street) (fdek 9? 2z0 It/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 PIPING (1 - 4 OUTLETS) GAS PIRING (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 4.00 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 = IpMzi *45 15/C NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE SUBTOTAL $ PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE S l� Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675