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1990, 11-08 Permit App: 90006027 Mechanical Fixture ,f WiY- /a /0 MECHANICAL PERMIT APPLICATION FORM �va� r� Information Worksheet d JOB STREET ADDRESS: I a O 1 l� ck. `t �,E'.i\� l /^ CITY/STATE/ZIP: j , kC \a.? 1 1 DL. PAROL NUMBER: UU1: 3Q3 -Wd.910 �)cT. .3118 OWNER• VN.CCK P.A4 e .`r,ramf PHONE NUMBER: lArrn 9U, 7,aai MAILING ADDRESS: E . 1 am t4 c Vi,I;i1., cA • [Oa) 9JaO1 (Street) (Cilty/State) (Zip) CONTRACTOR: C'T% r•tC� ��e,ak tic LICENSE NUMBER: l7 11\lC4'�C'�, C V 71,C_t 50 4 PHONE NUMBER: 3$--14 S aA R'� MAILING ADDRESS: , : 10013 - 7""r‘'A40 . • 1.1 99 RO3 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER I 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 = 1Q ,or.) HEATING EQUIPMENT +100,000 BTU x 15.00 = GAS PIPING (1 - 4 OUTLETS) x 4 . 00 = GAS PIPING (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 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 $ ja,oo PLUS: PROCESSING FEE + $ 25. 00 EQUALS: TOTAL PERMIT NOTE: MUM PERMIT IEE IS $35.00 FEE DUE = $ gip() SIGNATURE (71Aclak ' Spokane Coun 1e partment of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675