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1990, 11-29 Permit App: 90006468 Gas Log, PipingMECHANICAL PERMIT APPLICATION FORM Information -Worksheet JOB STREET ADDRESS: S /3 13 Reeves es taOit0- yitp3ria CITY/STATE/ZIP: '� C� mi- `rg/' PARCEL OWNER: MAILING ADDRESS: Si3i3..R '_y'eS (Street) CONTRACTOR: L(.�-ovC (�Xi L ENS E PHONE PHONE NUMBER: NUMBER: MAILING ADDRESS: (Street) (45-09-57) 314 97A / (City/State) (Zip) NUMBER: L.( lel /3/6//*) NUMBER: 3S-/7 3 - (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER DESCRIPTION OF UNITS (Zip) DUCTWORK SYSTEM WOODSTOVE/INSERT GAS:WATER HEATER HEATING ;EQUIPMENT <100,000 BTU , > _ HEATING EQUIPMENT +100,000 GAS; -PIPING (EA OUTLET) F,;:REFRIG-1-100M BTU (NOT A/C OR HEAT. PUMPYa REFRIG,,,3.61.7500M BTU _ REFRIG: 501`-1, 000M . BTU_ ,_ ' REFRIG;1, 001-1,.750M BTU _ ;: • _ REFRIG' +1, 750M',. BTU ' _ _ _ 'SHEAT "'_PUMP "&" AIR' CONDITIONER 0 3 ;''TONS;;`;, HEAT:PUMP &. AIR' CONDITIONER73 15'70NS HEAT PUMP,] & AIR CONDITIONER 15-3.0 ,TONS HEAT PUMP' & • AIR ' CONDITIONER 30-50...`; TONS HEAT PUMP & AIR CONDITIONER +50..;:TONS VENTILATING FANS :EVAPORATIVE 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 x25.00 _ x:'10:00 x'12.00 .'_ x 15.00 X 1.00 = AZ) x 12.00 ,: 140,4 .? < x 20.00, a,; H,, x 25-04"f1141'W x 35.00 t x60.00 x x12..00 IltAt 41,. x 25.00'= x .35:00' = 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 = / (>. Cc.) x 10.00 = !r x 50.00 = x100.00 = x 50.00 = x100.00= x 12.00 = x 15.00 = NOTE: MINIMUM PERMIT FEE s)�,I S $35.00 Thi_01)4(112 SIGNATURE (Q kl( (Ju224 Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260- (509) 456-3675 SUBTOTAL $ j / ,''(D PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE $ 1/43(0.co a