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1989, 09-21 Permit App: 89003538 Piping MECHANICAL PERMIT-APPLICATION FORM Information Worksheet JOB STREET ADDRESS: CO , / g cL CITY/STATE/ZIP: / 6, `,i PARCEL NUMBER: OWNER: � L�e\ 'X _ 7\ PHONE NUMBER: 9g -/V / MAILING ADDRE S: 3/ 1r� l-C < C (Street) (City/State) (Zip) CONTRACTOR: 4/1,-. . Q�� !_ " ( p ),(1 LICENSE NUMBER: �,►trws , J PHONE NUMBER: -21 MAILING ADDRESS: (1). 9 / 1 �/L _ ,/ - �� '' :' � �c'� (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE ,:'UMBER If EACH DESCRIPTION OF UNITS UNIT = AMOUNT DUCTWORK SYSTEM x$10. 00 = WOODSTOVE/INSERT x 25.00 = GAS WATER HEATER x 10.00 = HEATING EQUIPMENT <100,000 BTU x 12. 00 = HEATING EQUIPMENT +100, 000 BTU x 15. 00 = GAS PIPING (1 - 4 OUTLETS) j x 4 . 00 = dL' GAS PIING (5 OR MORE. EACH: ) x 1. 00 = REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12. 00 = REFRIG 101-500M BTU x 20. 00 = REFRIG 501-1, 000M BTU x 25.00 = REFRIG 1, 001-1,750M BTU x 35. 00 = REFRIG +1,750M BTU x 60. 00 = HEAT PUMP & AIR CONDITIONER 0-3 TONS _ x 12 . 00 = HEAT PUMP & AIR CONDITIONER 3-15 TONS _ x 20. 00 = HEAT PUMP & AIR CONDITIONER 15-30 TONS _ x 25. 00 = HEAT PUMP & AIR CONDITIONER 30-50 TONS _ x 35. 00 = HEAT PUMP & AIR CONDITIONER +50 TONS _ _ x 60. 00 = VENTILATING FANS x 10. 00 = EVAPORATIVE COOLERS x 10. 00 = TYPE I HOOD (PER 12 ' OR 12 ' PTN. OF HOOD) x 50. 00 = TYPE Ii HOODS _ _ x 10. 00 = CLOTHES DRYER x 10. 00 = RANGE x 10. 00 = GAS LOG x 10. 00 = MISCELLANEOUS (NOT COVERED ELSEWHERE) _ x 10. 00 = UNLISTED GAS APPLIANCE <400, 000 BTU_ _ _ x 50. 00 = UNLISTED GAS APPLIANCE >400, 000 BTU_ _ _ x100. 00 = USED APPLIANCE <400, 000 BTU x 50. 00 = USED APPLIANCE >400,000 BTU x100. 00 = AIR HANDLER <10, 000 CFM x 12 . 00 = AIR HANDLER >10, 000 CFM x 15. 00 = SUBTOTAL $ UU. PLUS: PROCESSING FEE + $ 25. 00 EQUALS: TOTAL PERMIT et NOTE: I IMUM PER1MT FEE IS /$35.00 FEE DUE = $ 9 SIGNATURE A AN- --,CW Ct f_, t `L `etc�c"l�� okan. County Department of Building and Safety �1 West 1 03 Broadway Avenue Spokane, WA 99260 (509) 456-3675