1990, 01-25 Permit App: 90000331 Furnace, Piping MECHANICAL PERMIT APPLICATION FORM 3�
Information Worksheet
•
JOB STREET ADDRESS: E• 7 7) .P.2AAA)
CITY/STATE/ZIP: �y)pkeZeb2_C(J1 . 99,210? PARCEL NUMBER: -/A - 15%2.
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OWNER: C E ackatyni`ls. PHONE NUMBER: q0&(0-16 67 (co) £/, 7 8y1 i
MAILING ADDRESS: F , '1716, KI14 JA/N jpelitt i Ja • 99e2.1 .2,
(Street) (City/State)!/ (Zip)
CONTRACTOR: �1E VaLEyRc'fl ,+ & =LICENSE NUMBER: A I�V/ti
E.11704 MONTGOMERY$T.1a PHONE NUMBER:
SPOKANE.WA
SOUS
MAILING ADDRESS:
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER 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 = /a•T°
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 =
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. 0F. 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 $ i 3 i 00
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT vv
NOTE: • ' T / EE/ S 5.00 FEE DUE _ $ 3 .
SIGNATURE %J��• siai41%1r
Sp , ne County Department of Building and Safety
West 130 Broadway Avenue Spokane, WA 99260 (509) 456-3675