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1990, 02-14 Permit App: 90000543 Furnace, PipingMECHANICAL MOP APPLICATION FORM_ 71 Information W rksheet JOB STREET ADDRESS: A.J. Costanzo 8209 E.Liberty CITY/STATE/ZIP: Spokane. Wa. 99212 OWNER: A.J. Costanzo MAILING ADDRESS: CONTRACTOR: same as above PARCEL NUMBER: c% 5 - /".7 PHONE NUMBER: 926-1080 (-)L (Street) Norco Heating & Air Cond. MAILING ADDRESS: 5051 E. Trent (Street) Inc. $ICENSE PHONE (City/State) (Zip) NUMBER: NORCOHA17ORZ NUMBER: 534-4975 MECHANICAL DESCRIPTION Spokane, Wa. 99212 (City/State) (Zip) WORKSHEET/FEE SCHEDULE NUMBER X EACH OF UNITS ITNIT 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 1,001-1,750M BTU REFRIG +1,750M BTU AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER FANS HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & VENTILATING 0-3 TONS _ 3-15 TONS 15-30 TONS 30-50 TONS +50 TONS EVAPORATIVE COOLERS TYPE L 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 1 1 = AMOUNT 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 = 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 = 12.00 1.00 NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE SUBTOTAL $ 13.00 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ 38.00 Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675