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1991, 10-18 Permit App: 91006946 Mechanical Fixtures
MECHANICAL PERMIT APPLICATION FORM InfcL-inaton Worksheet JOB ,STREET ADDRESS: /3c1/6 CITY/STATE/ZIP: Cj kJ/w W/J WQ1(P PARCEL NUMBER: OWNER: Ej e; 4- (A&nA(d Geri PHONE NUMBER: 9c91 - ,)3J3 MAILING ADDRESS E /3349 (0 Plc*, ©ktc?w w4 99Wrz2 (Street) (City/State). (Zip) CONTRACTOR: AIR DESIGN, INC: LICENSE NUMBER: AIRDEI*161JW. PHONE NUMBER: 487-4328 MAILING ADDRESS: E 1815. FRANCIS SPOKANE WA 99207 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH OF UNITS UNIT DESCRIPTION .DUCTWORK SYSTEM ,WOODSTOVE/INSERT GAS. WATER.HEATER HEATING. EQUIPMENT.<100,00Q BTU _ iEATING EQUIPMENT +100,000 BTU_, CAS PIPING (EA OUTLET)•. REFRIG..1-100M BTU (NOT A/C OR HEAT:' PUMP) RE'FRI G 101-500M BTU ' REFRIG.501-1,000M'BTU REFRIG. 1,001-1,750M BTU _ REFRIG:.+1, 750M BTU_ _ _ HEAT PUMP & AIR' CONDITIONER 0-3 TONS = HEAT PUMP & AIR CONDITIONER 3.-15 TONS HEAT PUMP ' & AIR CONDITIONER 15-30 '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 USED APPLIANCE >400,0.00 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 3.5.00._ x 60.00 = x 12.0C' .=. x 20.0.0' x 25.00, =; x 35.00 = x 60.00 . = x 10.00 = x 10..00..- x 50.00 x 10.0,0; X 10.00.:=' x 10.00 =' x 10.00 = X 10.00 =. x 50.00 = x100.00 = x50.00 = x100.00 = x 12.00 = x 15.00 = �,D0 00 NOTE: ,.MINIMUM,PERMIT ,FEE IS $35.00 SIGNATURE9/7 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. (50,9)' 456-3675