1990, 12-12 Permit App: 90006729 Shop 8
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: , St* �KiP(,0-0-e-TH @ ± -
CITY/STATE/ZIP: al'og 9-)L' PARCEL NUMBER:
OWNER: D-P 2 !iv iI W ALKE-/c PHONE NUMBER: 2-2-(o - 606g
MAILING ADDRESS: Z .23?/U /n n, -P-i RI) --w,0 LK F902-5—
(Street)
902(Street) (City/State) (Zip)
CONTRACTOR: 'q-) epAiSrgaCT7Dil LICENSE NUMBER: S CEJ CQ A) 1 3 i2 I2--
PHONE NUMBER: z2-119- CR
MAILING ADDRESS: SA- 49L7
(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 =
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 =
EVAPORATIVECOOLERS x 10.00
TYPE I HOOD (PER 12 ' OR 12' PTN. OF HOOD) x 50.00
TYPE II HOOD x 10.00
CLOTHES DRYER
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 $
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT
NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE = $
SIGNATURE
Spokane County Department of Buildin and Safety
West 1303 Broadway Avenue Spokane. WA 9260 1509) 456-3675