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1991, 01-23 Permit App: 91000243 Mechanical Fixtures z3 ? / 7 MECHANICAL PERMIT APPLICATION FORM . Information Worksheet I-1 JOB STREET ADDRESS: e; 'e,--r-,-->%. X.2'4'' ' S02---- // _ /S/07 CITY/STATE/ZIP: - t 4,..-l X776.PARCEL NUMBER: el,-,0,,,,,,p OWNER: GI, Q- PHONE NUMBER: ' `"7_2 `?;} MAILING ADDRESS: J r �. y' 71 (Street) (City/State) (Zip) CONTRACTOR:• AIR DESIGN, INC. LICENSE NUMBER: AIRDEI*161JW PHONE NUMBER: 487-4328 MAILING ADDRESS: E 1815 FRANCIS SPOKANE WA 99207 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE 1 NUMBER EACH 1 DESCRIPTION OF UNITS I XUNIT = 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 = %,.. •ca 0 HEATING EQUIPMENT +100, 000 BTU x 15.00 = GAS PIPING (EA OUTLET) / x 1.00 = / . 62 6-; 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 DTU 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 $ /3: Cc-) PLUS: PROCESSING FEE + $ 25. 00 ^ EQUALS : TOTAL PERMIT _-? NOTE: MINIMUM PERMIT FEE IS $35. 00 FEE DUE = $ - C2() SIGNATURE1ti i e--e, Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675