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1989, 11-22 Permit App: 89004826 Furnace
MECHANICAL PERMIT APPLICATION FORM Inforzi&eion Worksheet JOB STREET ADDRESS: S' • /9'D 6 /', O G,e655 / / CITY/STATE/ZIP: SidK19iUEt c�JN 9y30� PARCEL NUMBER: (/__ ` Y-) OWNER: 7' i lg Pito P ie TIES PHONE NUMBER: 9a y- 4/63'7 MAILING ADDRESS: E. / g9.0 /e ms dme . 5Pd k19,Ie, wN. 990704. (Street) (City/State) (Zip) CONTRACTOR:AOas('Al's 51/661" /1117 LICENSE NUMBER: ,4AJDosm /Sf Al 2_ PHONE NUMBER: 9021- of‘o MAILING ADDRESS: c•/3l`o 3 T,QtdT SVM-Ax, et). • y9GZ/� (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X 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 = 1a. 00 HEATING EQUIPMENT +100,000 BTU x 15.00 = GAS PIPING (1 - 4 OUTLETS) x 4 . 00 = GAS PIPING (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 HOOD _ 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 $ T,2 , o0 PLUS: PROCESSING FEE + $ 25. 00 EQUALS: TOTAL PERMIT NOTE: MINIMUM PERMI FEE IS $35.00 FEE DUE _ $ /7, SIGNATURE Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675