1991, 08-13 Permit App: 91004986 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Inform on Worksheet
JOB STREET ADDRESS: Sc 70 F ?-
PARCEL NUMBER: 2(6/12i3e6,
CITY/STA ZIP:
OWNER:
w,4. 99A%
MAILING ADDRESS:
CONTRACTOR:
'/- /fie
PHONE NUMBER: ?c9t.3S-g7
(Street)
c,
L.:
MAILING ADDRESS:
(City/State)
LICENSE NUMBER: AMQUAHE193N1
(Zip)
PHONE NUMBER: 92R-2100
(Street)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU _ _
HEATING EQUIPMENT +100,000 BTU.,_
GAS PIPING (EA OUTLET)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
EVAPORATIVE
AIR CONDITIONER 0-3 TONS
AIR CONDITIONER 3-15 TONS
AIR CONDITIONER 15-30 TONS
AIR CONDITIONER 30-50 TONS
AIR CONDITIONER +50 TONS _
FANS
COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
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
= 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 =
a De
ov
NOTE: MI,. - P IT FEE IS $35.00
SIGNATURE
SUBTOTAL
$ 36-op
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 67,60
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675