1989, 06-16 Permit App: 89001796 Wood StoveMECHANICAL PEDM!T.APPLICATION FORM L2
Information Worksheet
/ / y�1/'�T �/�
JOB STREET ADDRESS: T. 1 L/ / U )(i �/' i •
CITY/STATE/ZIP:
(s- er:Gicee
OWNER:i 1�Y1�- ISPHONE NUMBER: C� Sf St6o7
MAILING ADDRESS: cE).Q Lf (i(X G(epoxi es (_i' Ci
/57,6
(Street) (City/State) (Zip)
4PARCEL NUMBER:
/as/ - /n
CONTRACTOR:
MAILING ADDRESS:
LICENSE NUMBER:
PHONE NUMBER:
(Street)
!City/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 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
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
10.00
12.00
15.00
4.00
1.00
12.00
20.00
25.00
35.00
60.00
12.00
20.00
25.00
35.00
60.00
10.00
10.00
50.00
10.00
10.00
10.00
x 10.00
x 10.00
x 50.00
x100.00
x 50.00
x100.00
x 12.00
Ix 15.00
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
$ asuD
PLUS: PROCESSING FEE
$ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675