1991, 08-28 Permit App: 91005368 FurnaceJOB STREET ADDRESS:
CITY/STATE/ZIP:
MECHANICAL PERMIT APPLIUATION FOKm
Information Worksheet
J� ✓
%(, A q9c)--06.0 PARCEL NUMBER:
OWNER: h1 (0_ROLL C . C t Q� 0 Az) PHONE NUMBER: 9 d 7 - 7 c / 3
MAILING ADDRESS: TO 37 ��-
CONTRACTOR:
(Street)
'(City/State) (Zip)
-yL LICENSE NUMBER: $21 - lq " 37 AJ/
PHONE NUMBER: Tbc - //70 ,r 3 '/
MAILING ADDRESS: 00 6 70 7
(Street)
/4f44 a t C 2 -992-)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
= AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIRING (5 OR MORE. EACH:)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS _
+50 TONS
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
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
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 1
x - =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/ a. 00
SIGN
NOTE: MINIMUM E IT FEE0:1$35.00
$35.00
ATURE " 4 4 I' 1
SUBTOTAL
$ ( A •CO
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$37
Spokan Co �� Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675