1989, 10-04 Permit App: 89003801 FurnaceJOB STREET ADDRESS:
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
E. 13923 Nixon
CITY/STATE/ZIP: Spokane, Wa. 99216 PARCEL NUMBER:
OWNER: rank Jolley
MAILING ADDRESS: same as above
CONTRACTOR: Norco
MAILING ADDRESS:
(Street)
Heating & Air Cond.- Inn_
E. 5051 Trent
PHONE NUMBER: 926-8791
(City/State) (Zip)
LICENSE NUMBER: NORCOHC17ORZ
PHONE NUMBER: 534-4975
(Street)
Spokane, Wa. 99212
(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 PIING (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 +1,75OM BTU
0-3 TONS
3-15 TONS _
15-30 TONS _
30-50 TONS _
+50 TONS
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
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
1
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 4.00 =
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 =
12.00
NOTE: MINIMUM PEI! FEE I8 $35.00
SIGNATURE /�'h cl „ e�
Spokane County Department of Building and Safety5
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-367
SUBTOTAL
$ 12.00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 37.00