1989, 05-26 Permit App: 89001461 Wood StoveJOB STREET ADDRESS:
MECHANICAL PERfiIIT.$PPLICATION FORM
Information Worksheet
(CITY/STATE/ZIP: n A PARCEL NUMBER:
OWNER:
\/MAILING ADDRESS:
CONTRACTOR:
)(MAILING ADDRESS:
ilk or
(Street)
PHONE NUMBER* 23.4 L -U -F, L-1
rc\O(rn( d ADi&
(City/State) (Zip)
S • np3
(Street)
LICENSE NUMBER:
PHONE NUMBER:
Y\1nr in(cp SP() l ccn GiC7Qtt,
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
1
DUCTWORK SYSTEM
NUMBER X EACH
OF UNITS UNIT
= AMOUNT
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,1000 BTU
HEATING EQUIPMENT +100,1000 BTU
GAS PIPING (EACH OUTLET:)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP),
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU II
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER 0-3 TONS
AIR CONDITIONER 3-15 TONS
AIR CONDITIONER 15-30 TONS
AIR CONDITIONER 30450 TONS
AIR CONDITIONER +50 TONS
FANS
EVAPORATIVE COOLERS
HOODS
CLOTHES DRYER
RANGE
GAS LOG
UNLISTED GAS APPLIANCE
AIR HANDLER - 10,000 CFM
x$ 6.50 =
x 10.00 =
x 6.50 =
x 9.00 =
x 11.00 =
x .50 =
x 9.00 =
x 16.50 =
x 22.50 =
x 33.50 =
x 56.00 =
x 9.00 =
x 16.50 =
x 22.50 =
x 33.50 =
x 56.00 =
x 4.50 =
x 6.50 =
x 6.50 =
x 6.50 =
x 6.50 =
x 6.50 =
x 20.00 =
x 9.00 =
In.no
NOTE: MINIMUM PERMIT FEE IS $20.00
Signature Y-fr_r1a+tec ,'rtei A
SUBTOTAL
$
PLUS: PROCESSING FEE
+ $ 15.00
EQUALS: TOTAL PERMIT
FEE DUE
= $c 5DO
Spokane County Department of Building and Safety
West 1303 Broadwav Avenue Snokane. WA 99260 (5091 456-3675