1989, 03-20 Permit App: 89000528 FurnaceJOB STREET ADDRESS;
CITY/STATE/ZIP:
OWNER:
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
MAILING ADDRESS:
PARCEL NUMBER:
PHONE NUMBER:
(Street) (City/State) (Zip)
CONTRACTOR: I/�` , D51 LICENSE NUMBER:/?A7/3 02'j' d Cg
PHONE NUMBER: 3,72S --‘,87,K
MAILING ADDRESS:
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
NUMBER
OF UNITS
X EACH
UNIT
(Zip)
= AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (EACH OUTLET:)
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
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 =
NOTE: MINIMUM PERMIT FEE IS $20.00
Signature
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 15.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675