1990, 09-19 Permit App: 90004740 FurnaceMECHANICAL PERMIT APPLICATION FORM Le )). O &
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JOB STREET ADDRESS ,NJt,, 3
CITY/STATE/ZIP: PARCEL NUMBER:
)jdi1/4/6(
OWNER
IA
MAILING ADDRESS:
CONTRACTOR:
RL -9
PHONE NUMBER:40t
(Street)
PHOi1E NUMBE
MAILING ADDRESS: g:(1:jk3i1)LbL).--)
(Street)
z-(-tr-r7L-2
(City/State) (Zip)
rill
LICENSE NUMBER:
C ty/ tate)
(Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE /
NUMBER X EACH
DESCRIPTION OF UNITS ,'NIT = AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (1 - 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 &
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
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
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NOTE:
SIGNATU
0,
0
f
SUBTOTAL
�C$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
7x 12.00
x 15.00
1
$ 0,X\
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County ' epartment of Building and Safety
1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
--- $37,6)0