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1992, 09-29 Permit App: 92008178 Mechanical Fixtures45-331A,1115 41. 11 $7(665 6 -MECHANICAL P,ER""IT APPLICATION FORM �n� L�5 1 Information Worksheet JOB STREET ADDRESS: 4202 S. Pondra Dr. -3773 a ao3 CITY/STATE/ZIP: Spokane, WA 99206 PARCEL NUMBER: OWNER: David Goering PHONE'NUMBER: .928-6218 MAILING ADDRESS: (Street) (City/State) (Zip) CQNTRACTOR: Allied Heating, Inc. LICENSE NUMBER: ALLIEI*20004 MAILING ADDRESS: .9309 E. Trent (Street) PHONE NUMBER: 928-8252 Spokane. WA 99206 (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH OF UNITS (UNIT ,DESCRIPTION DUC1TWORK SYSTEM WOCjDSTOVE/INSERT WI WATER HEATER HEP.,TING EQUIPMENT <100,000 BTU HEP.ITING EQUIPMENT +100,000 BTU GAS) PIPING (EA OUTLET) REERIG 1-100M BTU (NOT A/C OR HEAT PUMP) REFRIG 101-500M BTU REERIG 501-1,000M BTU REF;RIG 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 EVAAPORATIVE COOLERS T�YIE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE II HOOD CLQTHES DRYER RANGE CSA:) LOG MI;jCELLANEOUS (NOT COVERED ELSEWHERE) QNPISTED GAS APPLIANCE <400,000 BTU UNIkISTED GAS APPLIANCE >400,000 BTU USiFD APPLIANCE <400,000 BTU USp APPLIANCE >400,000 BTU AI4 HANDLER <10,000 CFM A,I1HANDLER >10,000 CFM a = AMOUNT X$10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = 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 = JO•00 I�.00 NOTE: MINIMUM PERMIT FEE IS $35.00 SI!$NATURE SUBTOTAL $ az/. co PLUS:.PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE _ $ 49,x1 Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675