1992, 02-18 Permit App: 92000837 Mechanical FixturesSTREET;. ADDRESS:
Y/STATE/ZIP:
WNER:
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet•
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i04343-
PARCEL
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PARCEL NUMBER:
PHONE NUMBER:
ILING ADDRESS:
(Street) (c'ity/State) (Zip)
LICENSE NUMBER: P7//,(S/)[ *ic A,Ar '
ONTRACTOR:
PHONE NUMBER:
1' /. f •..
ILING ADDRESS:
(Street)
(City/State)
(Zip)
MECHANICAL WORKSHEET/FEE, SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
UCTWORK SYSTEM
OODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
EATING EQUIPMENT +100,000 BTU
GAS PIPING (EA OUTLET)
REFRIG,1-100M BTU (NOT A/C OR HEAT PUMP)
FRIG 101-500M BTU
FRIG 501-1,000M BTU
EFRIG1,001-1,750M BTU
FRIG -+1,750M BTU.
EAT`PUMP',& AIR CONDITIONER
EAT:PUMP & AIR. CONDITIONER
SHEAT PUMP& AIR CONDITIONER
HEAT
PUMP -& AIR CONDITIONER
HEAT PUMP: ' &
VENTILATING
£EVAPORATIVE
-TYPE I HOOD
"TYPE II HOOD
CLOTHES DRYER
AIR CONDITIONER
FANS
COOLERS
(PER 12' OR 12' PTN. OF HOOD)
0-3 TONS _
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS _
ALOG •
ISCELLANEOUS (NOT COVERED ELSEWHERE)_'_
LISTEDGAS' APPLIANCE.:r<400, 000 BTU_
UNLISTED GAS'APPLIANCE>400,000 BTU_ _
SEDAPPLIANCE <400,000 BTU
SED APPLIANCE >400,000 BTU
AIRHANDLER <10,000 CFM
AIR HANDLER >10,000 CFM
= 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
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675