1990, 08-21 Permit App: 90004090 Furnace, ACJOB STREET ADDRESS:
MECHANICAL PERMIT,APPLICATION FORM
Informa Lion Worksheet
CITY/STA /ZIP: P O Yo ni
OWNER:G
-1
MAILING ADDRESS:
•
CONTRACTOR: .1-1)c, p 0 NIL' CENSE
MAILING ADDRESS:
(7(-2, jf &� P�IONE
v
ou
/& PARCEL
Cia05
PHONE
NUMBER:
NUMBER:
(Stret�
1
(Street)
(City/State) (Zip)
NUMBER:
NUMBER:
�Tl ci s 153M
sesta
latardir 4,
ty/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE /
NUMBER X/EACH
DESCRIPTION OF UNITS UNIT
= AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (1 - N4 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 +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0-3 TONS
HEAT. PUMP & AIR CONDITIONER 3-15 TONS
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' 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
r
L
$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
ra 'co
N
SIGNA
TE:
RE
IN U
Spokane
st 1303 Br
,L7)/17135.00
SUBTOTAL /
$ a74.m
PLUS: PROCiSSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 4.00
ounty Department of Building and Safety
dway Avenue Spokane, WA 99260 (509) 456-3675
/9