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1992, 01-15 Permit App: 92000262 Mechanical Fixturesa7 i 11 MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: CITY/STATE/ZIP: OWNER: �s MAILING ADDRESS: E ry 12 0 }'Yt,L A `1 (72.-1( PARCEL NUMBER: PHONE NUMBER: 2_ - S-7 3 3 (Street) CONTRACTOR: (City/State) (Zip) LICENSE NUMBER: A- ' 2r 1 I W PHONE NUMBER: `'Ig` 7- y 12- r MAILING ADDRESS: '` , \V -J 'F, .& (Street) Lk.) `-?I 2v 7 ty/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE N'L r BER X EACH DESCRIPTION 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 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 30-50 TONS HEAT PUMP & AIR CONDITIONER +50 TONS VENTILATING FANS EVAPORATIVE COOLERS TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE II HOOD C OTNES 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 = 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 0C x720.00 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 = \2 c c) \2. C0 NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE (1),,.44,J, Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675 SUBTOTAL PLUS: PROCESSING FEE 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ `i 9.0 0