1990, 08-01 Permit App: 90003672 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM 4415/- 4a-21
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JOB STREET ADDRE'S: , / �. eZ72 D /
CITY/STATE/ZIP
OWNER:
MAILING
DDRF«SS
CONTRACTOR:
(Stree
a
.67
,,allh%/
01
MAILING ADDRESS: (a/
(Street)
PARCEL
BER:
PHONE NUMBER:
4-'
(C y/State) (Zip)
LICENSE NUMBER: Se-//-A-S.E--* - 2;Ati
PHONE NUMBE' : 2,c-/(% - //%D K 44 /
' (QJ /Om 41r2/I
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 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
USED APPLIANCE <400;000 BTU'
USED APPLIANCE >400,000, -BTU
AIR HANDLER <10;000CFM','`"
AIR HANDLER >10,000'CFM
/
1
l
x$10.00
x 25.00
x 10.00
x 12.00
X 15.QQ
X
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 .=
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/ao
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NOTE: /MyfIIMUM PE IT FEE IS $35.00 -
t _
Spokane County Department' of Building .and -Safe t- .'
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: -TOTAL PERMIT
--FEE-DUE -