1991, 11-21 Permit App: 91008108 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM
Information�Worksheet C c-k- `Jo t317
JOB STREET ADDRESS: , ( (0 /Y" e izzuf
CITY/STATE/ZIP: 4 4, i ' ,, &A 992i( PARCEL NUMBER:
OWNER: 0 0 PHONE NUMBER: 41 fJ ' a
MAILING ADDRESS:
(Street) - (City/Stats) (Zip)
CONTRACTOR• A&MUATYHEQLIATING LICENSE NUMBER: aHq�xE149Nt
. 1 g,u 'ND ANA A IE• PHONE NUMBER: 928-2100
SPOKANE, WA 99216
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,00
HEATING EQUIPMENT +100,000 BTU x 15.00 =
GAS PIPING (EA OUTLET) I x 1.00 = /. 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. 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 $ 13.0
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT p
NOTE: MI + IM PE' EE IS $35. 00 FEE DUE = $ 3 8, D o
S1GNA'I'UItE ,,. 14$ )., - -
Spokane S Safety
West 133 Broadway AenueSpokane, WA99260 (519) 456-3675