1992, 02-05 Permit App: 92000625 Mechanical Fixtures aos5 -0/57 (-Filt ,,
MECHANICAL PE MIT`APPLICATION FORM op - ZS 0 CoL �+ ; Information Worksheet ,�„t
� Ctc/`eS 19006 E . Sprague I I '
JOB STREET ADDRESS:
CITY/STATE/ZIP: Greenacres . Wa 9901R PARCEL NUMBER
7 jsl:
OWNER: Jack Main PHONE NUMBER: 928-6206 f
MAILING ADDRESS: tog
(Street) (City/State) (Zip) 11a
CONTRACTOR: Allied Heating , Inc . LICENSE NUMBER: ALLIEI*20004 * _ `
PHONE NUMBER: 928-8252 ,:M
MAILING ADDRESS: 9309 E . Trent S•okane WA 99206T ,°
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE l
NUMBER X EACH e-t.-
DESCRIPTION OF UNITS UNIT = AMOUNT " ';
DUCTWORK SYSTEM 1 •x$10.00 = /O. 00
WOODSTOVE/INSERT x 25.00
GAS WATER HEATER x 10.00 = y ',
HEATING EQUIPMENT <100,000 BTU ( x 12.00 = )a,coo �;a
HEATING EQUIPMENT +100,000 BTU x 15. 00 =
GAS PIPING (EA OUTLET) 44
f x 1.00 = I ,O(
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12.00 = ``
REFRIG 101-500M BTU X 20.00 = ett
REFRIG 501-1, 000M BTU x 25.00 = ,
REFRIG 1, 001-1,750M BTU x 35.00 =
REFRIG +1,750M BTUx 60.00
HEAT PUMP & AIR CONDITIONER 0-3 TONS _ x 12 . 00 = � `
HEAT PUMP & AIR CONDITIONER 3-15 TONS _ x 20.00= f #
14
HEAT PUMP & AIR CONDITIONER 15-30 TONS _ x 25.00 = 'T ,
HEAT PUMP & AIR CONDITIONER 30-50 TONS _ x 35.00 =
HEAT PUMP & AIR CONDITIONER +50 TONS _ _ x 60.00 = k`
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 LOG1L2_ �' R- x 10.0o _ ,
MISCELLANEOUS (NOT COVERED ELSEWHERE)_ _ I x 10. 00 = jo,o \ ..;
UNLISTED GAS APPLIANCE <400,000 BTU_ _ x 50.00 = ,a;
UNLISTED GAS APPLIANCE >400, 000 BTU_ _ _ x100. 00 = 4.
USED APPLIANCE <400, 000 BTU x 50.00 = 1 �
USED APPLIANCE >400,000 BTU x100.00 = M�
AIR HANDLER <10,000 CFM x 12 . 00 =
AIR HANDLER >10,000 CFM x 15.00 = ,,,,
SUBTOTAL $ e33 o :
PLUS: PROCESSING FEE + $ 25.04, 4
EQUALS: TOTAL PERMIT ?
NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE _ $ , . ,1
SIGNATURE j./ CA P � � �%
Spokane County Department of Buildin�q and Safety "* >''
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 ,iy.
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