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1990, 03-05 Permit App: 90000721 Fireplace, WoodstoveJOB STREET ADDRESS: CITY/STATE/ZIP: OWNER: Q�gbd. .)jls MAILING ADDRESS:,. /7102,_ MECHANICAL PERMIT APPLICATION FORM Informatiga Worksheet PHONE MJ14BER: !2oZ L( IT, I 14-40.0.4/Ar AA0S 9 -,o %L (Street) (City/State) (Zip) CONTRACTOR: LICENSE NUMBER: PHONE NUMBER: MAILING ADDRESS: :(Street) (City/State) (Zip) MECHANICAL WORKSHRET/FEE DESCRIPTION' SCHEDULE NUMBERX OF UNITS ,EACH UNIT AMOUNT DUCTWORK SYSTEM WOODSTOVE/INSERT - _ _ _ GAS WATER HEATER HEATING EQUIPMENT <100, 000BTU � - _ - - HEATING EQUIPMENT +100,000 BTU _ GAS PIPING (EA OUTLET) _ _ _ _ REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) REFRIG 101 -SOON BTU' REFRIG 501-1,000M BTU_- - REFRIG 1,001-1,750M BTU- - - - - _ - REFRIG +1,750M 13TU - - - - - - HEAT PUMP & AIR CONDITIONER 0-3 TONS HEAT PUMP & AIR CONDITIONER 3-15 TONSr-_ 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':3R 12' PTI. 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 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` = SUBTOTAL $ PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT NOTE: IMUM PERMIT FEE IS $35.00 FEE DUE = $- S I GNATURE '7.5 _ D Spokane County- Department of Building and Safe#y West 13tH Broadway venue Spokane, WA 99260 (5 9) 456-3675