1990, 07-17 Permit App: 90003359 Heat PumpMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: 0 c r ��
CITY/STATE/ZIP: 5/14,.>-/. / 4 iv qcl ,‘ PARCEL NUMBER:
OWNER: t T6r,C'�zwo�
MAILING ADDRESS:
CONTRACTOR:
PHONE NUMBER:
(Street)
`�_^•' . -4. l OV 4 V ? % Vim - b .�
MAILING ADDRESS: S / <? /l/c1' ff
(City/State)
LICENSE NUMBER: Csiyy/
PHONE NUMBER:
(Street)
(Zip)
leo 3
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS TTNIT = AMOUNT
DESCRIPTION
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000
HEATING EQUIPMENT +100,000
GAS PIPING (EA OUTLET)
BTU
BTU
REFRIG 1-100M BTU (NOT A/C
REFRIG 101-500M BTU
OR HEAT PUMP)
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
VENTILATING FANS
0-3 TONS _
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12'
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
PTN. OF HOOD)
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
x$10.
x 25.
x 10.
x 12.
x 15.
x 1.
x 12.
x 20.
x 25.
x 35.
x 60.
x 12.
x 20.
x 25.
x 35.
x 60.
x 10.
x 10.
x 50.
x 10.
x 10.
x 10.
x 10.
x 10.
x 50.
x100.
x 50.
x100.
x 12.
x 15.
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
00
°.
NOTE: MINIMUM PERMIT FEE IS $35.00
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 37o