1991, 04-26 Permit App: 91002099 FurnaceMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: S. 3512 Sundown Drive
,DO??
CITY/STATE/ZIP: Spokane, WA 99206
OWNER: Mike Simock
PARCEL NUMBER:
PHONE NUMBER: 509/926-4287
MAILING ADDRESS: Same As Above
(Street)
CONTRACTOR:Steinmetz Heating & A/C
MAILING ADDRESS: N. 2206 Pines Road,
(City/State) (Zip)
LICENSE NUMBER: STEINHA147KF
PHONE NUMBER: 509/922-2034
(Street)
Spokane WA 99216
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT
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
TU .
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
EVAPORATIVE
TYPE I HOOD
TYPE II HOOD
CLOTHES DRYER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
COOLERS
(PER 12'
RANGE
OR 12'
PTN. OF HOOD)
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
1
0
= AMOUNT
x$?0.00 =
x 25.00 =
x 10.00 =
x12.00 =
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 =
12.00
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
J
SUBTOTAL
$12.00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
$37.00
Spokane County Department of Building_ and Safety
West 1303 Broadway Avenue Spokane. WA 9260 (5091 456-3675