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1989, 09-27 Permit App: 89003654 Gas Log, Piping MECHANICAL PERMIT APPLICATION FORM Information Worksheet i JOB STREET ADDRESS: •C/ _/ %,: 7-4// ' ' ( -, ,'-U' ( r CITY/STATE/ZIP: I '"y= "2' - ''t" `' PARCEL NUMBER: 'ice OWNER t ) - : 1 f:-2 - PHONE NUMBER: ,77,.>.' !, r'4 c / MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: Heat Transfer Inc . LICENSE NUMBER: HEATTI - 188LN PHONE NUMBER: 328-3400 MAILING ADDRESS: N. 1008 Ruby Spokane , Wa . 99202 • (Street) - (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER I 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 = HEATING EQUIPMENT +100, 000 BTU -17-0:-e- 15 . 00 = ` GAS PIPING (1 - 4 OUTLETS) / x 4 . 00 = °.2 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 = RAN G E . x 10. 00 = GAS LOG / x 10 . 00 = /c'i n () 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 $ / V °,1 • • • PLUS : PROCESSING FEE + $ 25 . 00 ^ EQUALS : TOTAL PERMITr NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE = $ =-3} n SIGNATURE ? f} - /`��/_ - Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675