1990, 09-27 Permit App: 90004960 Heat PumpJOB STREET ADDRESS:
MECHANICAL PERMIT APPLICATION FORM
Ii farm'a'tion Worksheet
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CITY/STATE/ZIP: \0C 4? P 7i)ARCEL NUMBER: - li .�
OWNER: Rafk &,(',i_e/tzPHONE NUMBER: /,,,)//
/14)..G) �1i �,�/
MAILING ADDRESS :. /1/1-00 ' wl.dit 7J ,9 'r.. f t),' jc7.6
Street)ity/State) (Zip)
LICENSE NUMBER: S? - 77E - 37c)-/ T
PHONE NUMBER: 6"/ S ' " ! ( 70 K.3616,
6'- A ,3
(7)
CONTRACTOR: / -A4h, -7`L--
MAILING ADDRESS: ,Pd / 3707
(Street)
(04 94 27)
(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 PIVING (5 OR MORE. EACH:)_
REFRIG 1-100M BTU (NOT A/C OR HEATPUMP)
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 CONDITIONE 2.15-30 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
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 =
x 10.00 =
x 12.00 =
x 1).22 =
x 8-=
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 =
50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x140.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00
, 00
NOTE: MINIMUM T FEE IS $35.00
SIGNATURE $ ACS _ ' �0A/0-0
Spokane Co De
SUBTOTAL
PLUS: PROCESSING FEE
S, 25.00
EQUALS: TOTAL PERMIT
FEE. DUE
$ 37,00
rtment of Building _ and Sats
Arr. nr_-s