1990, 04-24 Permit App: 90001656 Move WoodstoveMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: $ 38 /,3 ivi
CITY/STATE/ZIP: ,c kA-,ve, lV/1-79266 PARCEL NUMBER:
OWNER: K FNiveri C,LS e7./ PHONE NUMBER: 702 y -DSS 7
MAILING ADDRESS: SArnE 4 iv
(Street)
(City/State)
(Zip)
CONTRACTOR: LICENSE NUMBER:
PHONE NUMBER:
MAILING ADDRESS:
(Street)
City/State) (Zip)
MECHANICAL WORKSHEET/FEE, SCHEDULE
NUMBER
DESCRIPTION OF UNITS
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER _
HEATING EQUIPMENT <100,000
HEATING EQUIPMENT.+100,000
GAS PIPING,;:(EA OUTLET) _
REFRIG 1-100M ,BTU : (NOT A/C
REFRIG.101-500M BTU_
REFRIG..501-1,000M.,BTU:.
REFRIG `1,001-1,750M 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 30750 TONS,
HEAT PUMP & AIR CONDITIONER'+50 TONS
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE 'I HOOD (PER 12' OR 12'. - PTN. OFA ..HOOD);
TYPE-II.HOOD`
CLOTHES' DRYERJ.
..
RANGE
GAS LOG_.
MISCELLANEOUS (NOT COVERED ELSEWHERE)_
UNLISTED GAS APPLIANCE <400,000 BTU_ _
UNLISTED GAS APPLIANCE >400,000
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM
X EACH
ITNIT
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."
."
x 60.00 =
x)12.00
x;
20.00
x 25.00 =
x 35.00 =
x , 60.00,
x 10.00
x 10.00 =
x50.00.=
X ;; 10.00 =
x 10.00,.
xAlf.00
x`=.10 00
x 10.00.
x 50.00 `
x100.00 =
x 50.00 =
x100.00 =
x 12.00
x 15.00 =
= AMOUNT
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $
Spokane County Department of Building and Safety
West 13113 Broadway Avenue Spokane, WA 99260 (509) 456-3675.