1978, 08-24 Permit App: 90004585 Furnace, Water Heater MECHANICAL PERMIT APPLICATION FORM
,Information Worksheet
JOB STREET ADDRESS: N. 4304 Keller 07j5-“
CITY/STATE/ZIP: Spi ne, Wa 99216PARCEL NUMBER: �j!(l (�� d2- !?
OWNER: Bob Degenhardt PHONE NUMBER: 924-4953
MAILING ADDRESS: N_ 4304 Keller Spokane, Wa 99216
(Street) (City/State) (Zip)
CONTRACTOR:Norco Heating & Air Cond. Co. LICENSE NUMBER: NORCOHA17ORZ
PHONE NUMBER: 534-4975
MAILING ADDRESS: E. 5051 Trent _,Spokane, Wa 99212
(Street) (City/State) (Zip)
si .roe
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT = AMOUNT
DUCTWORK SYSTEM x$!0. 00 =
WOODSTOVE/INSERT x 25. 00 =
GAS WATER HEATER X x 10.00 = jQ.Q0
HEATING EQUIPMENT <100, 000 BTU x x 12 . 00 - 12.00
HEATING EQUIPMENT +100, 000 BTU x 15. 00 =
GAS PIPING (EA OUTLET) _ 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 =
P.EFRIG 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 =
RANGE x 10. 00 =
GAS LOG x 10. 00 =
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 $ 24_00
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT
NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE - $ 44.00
SIGNATURE z- 7,1 , „
Spokane County Department of Building and Safety
1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675