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1990, 03-07 Permit App: 90000770 Mechanical Fixtures MECHANICAL PERM. IT. PPLICATION FORM Information Worksheet JOB STREET ADDRESS: /2/5/ CITY/STATE/ZIP: �`�. /,r�. v, PARCEL NUMBER: OWNER: 66t A c/�jn a /Ci PHONE NUMBER: 9;4---- r 7 f 3 MAI LING ADDRESS: ,c6/1:2_ (Street) / (City/State) (Zip) CONTRACTOR:, _t_1120_,__,„ }--)-04_. CoLICENSE NUMBER: L CL A/'M 1-71/ ?� PHONE NUMBER: 6 -w?yy j MAILING ADDRESS: /('" "-I9 1/(X 0� 2 t� � (.1 4 (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 = /c e- HEATING EQUIPMENT <100, 000 BTU - / x 12. 00 = PZe° 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. OF HOOD) x 50. 00 = TYPE II HOOD X 10. 00 = CLOTHES DRYER x 10. 00 = RANGE x 10. 00 = GAS LOG j x 10. 00 = /414 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 $ 'T"i PLUS: PROCESSING FEE + $ 25. 00 EQUALS: TOTAL PERMIT- 7 `>�? NOTE: MINIMUM PERM F „ 1,p, $35.00 FEE DUE _ $ SIGNATURE / Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675