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1990, 09-19 Permit App: 90004744 Gas PipingMECHANICAL PERMIT APPLICATION FORM Infon-ration Worksheet JOB STREET ADDRESS: Al- w yz kGr - CITY/STATE/ZIP:l!' PARCEL NUMBER: OWNER: ,/ / PHONE NUMBER: MAILING ADDRESS: ( treet) (City/State) (Zip) CONTRACTOR:LICENSE NUMBER: 'p PHONE NUMBER: MAILING ADDRESS: (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE BER DESCRIPTION I OFUUNITS I XUNITH I = AMOUNT DUCTWORK SYSTEM_ WOODSTOVE/INSERT _ _ _ _ _ _ _ _ _ _ _ _ GAS WATER HEATER HEATING EQUIPMENT <100,000 BTU _ _ _ _ _ HEATING EQUIPMENT +100,000 BTU _ _ _ _ _ GAS PIPING (EA OUTLET) _ _ _ _ _ _ _ _ _ REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) REFRIG 101-500M BTU_ REFRIG 501-1,000M BTU_ _ _ _ _ _ _ _ - - REFRIG 1,001-1,750M BTU REFRIG +1,750M BTU _ _ _ _ _ _ _ _ _ HEAT PUMP & AIR CONDITIONER 0-3 TONS _ _ HEAT PUMP & AIR CONDITIONER 3-15 TONS _ HEAT PUMP & AIR CONDITIONER 15-30 TONS _ HEAT PUMP & AIR CONDITIONER 30-50 TONS _ HEAT PUMP & AIR CONDITIONER +50 TONS VENTILATING FANS - - - - - - - - - - EVAPORATIVE COOLERS_ TYPE I HOOD (PER 12, OR 12' PTN. OF HOOD) TYPE II HOOD - - - - - - - - - - - - - - CLOTHES DRYER RANGE- - - - - - - - - - - - - - GAS LOG'- ----- - - - - - - - - - - - - - - - - - MISCELLANEOUS (NOT COVERED ELSEWHERE)_ _ UNLISTED GAS APPLIANCE <400,000 BTU_ _ _ UNLISTED GAS APPLIANCE >400,000 BTU_ _ _ USED APPLIANCE <400,000 BTU_ USED APPLIANCE >400,000 BTU_ AIR HANDLER <10,000 CFM - - - _ - _ _ _ AIR HANDLER >10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675 X$10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x 1.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = X 60.00 = x 12.00 = x 20.00 = x 25.00 - x 35.00 = x 60.00 = x 10.00 = x 10.00 = x 50.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = , _ SUBTOTAL $ PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675