1990, 12-28 Permit App: 90006948 Mechanical FixturesECHANICAL PERM!! APPLICATION_ FORM
nformation. Worksheet .., ✓>
Is) AJ J: IZ1-, 7Y -L C .`c/ to lam(
;JOB'STREET..ADDRESS:i-
3.
CITY/STATE/ZIP: n ` `AJ�� vJr
,OWNER:
,. CQ
PHONE;NUMBER:
•
ARCEL NUMBER:
i., r...1
MAILING. ADDRESS: .-,
Street) . - •.
,ci
'•(City/State) =(Zip)
CONTRACTOR: \fix®" c- Itt 1-:.-.LxCENSE N[J1+IBER:' es Acsi r I 34-4 (_p'
,.
`+ PHONE NUMBER: CiLZ - S OflpAS
MAILING ADDRESS: 1:150-t'c0 j'
1. .. . "..:(Street) - t (C1 tate) )
:MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 ETU
HEATING EQUIPMENT +100,000 BTU
.GAS PIPING (1 - A :OUTLETS).
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
gREFRIG +1,750M BTU .
HEAT PUMP & AIR CONDITIONER 0-3 TONS
4`... HEAT PUMP & AIR CONDITIONER 3=15 TONS
HEAT PUMP & AIR CONDITIONER 15-30'TONS
HEAT PUMP &'AIR CONDITIONER .30-50:TONS
,•HEAT PUMP & AIR CONDITIONER +50 TONS "
VENTILATING FANS.' •
'EVAPORATIVE -COOLERS
TYPE I' HOOD,..(PER;12'-vOR 12!PTN. OF HOODI
':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
1
9
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 =
x 10.00 =
x 10.00 =
x 10.00 =
x10.00 =
x 10.00 =
x 50.00.=
x100.00 '_
x 50.00'=
x100.00 =
x 12.00 '
x 15.00 =
= AMOUNT
Zv
2__C7\..
NOTE:
SIGNATURE
INIMUMPERMIT ;FEE IS $35.00 --
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane_County Department'af Building int! Satety
$t "