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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