1989, 10-13 Permit App: 89004029 Woodstove MECHANICAL PER�NR :: ' APPLICATION FORM
InformatOn Worksheet
JOB STREET ADDRESS: E.• I eo z4 RINteruzou. qad
CITY/STATE/ZIP: &ceenacres WA 9-)oi10 PARCEL NUMBER:
OWNER: nl ictICie.1 A . Ke it e2 PHONE NUMBER: q2.8 - 1(022_
MAILING ADDRESS: E • leo z 4- Rx‘rerc,.3c4 Re( &ceenc*.cx s LOA 9%o14,
(Street) _..) (City/State) (Zip)
CONTRACTOR: ✓ LICENSE NUMBER: /
PHONE NUMBER:
MAILING ADDRESS:
Street) �(City7State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION OFFUUNNIITTS XUNITH = AMOUNT
DUCTWORK SYSTEM - x$10.00 =
-
WOODSTOVE/INSERT 1 _ x 25.00 = ,2$; oo
GAS WA TEP, ER x 10.0 0 =
HEAT _ _ •-- -
HEATING EQUIPMENT <100,000 BTU �_ x 12.00 =
HEATING EQUIPMENT +100,000 BTU x 15.00 =
GAS PIPING (1 - 4 OUTLETS) x 4.00 =
GAS PIING (5 OR MORE. EACH: ) _ 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 BTUx 25.00 =
REFRIG 1,001-1,750M BTU a 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 $ aS oa
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT
NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE = $ 5-6,60
SIGNATURE
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675