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1990, 02-26 Permit App: 90000645 Range, Piping
MECHANICAL POW APPLICATION FORM Information Worksheet JOB STREET ADDRESS: CITY/STATE/ZIP: %L� PARCEL NUMBER: OWNER: PHONE NUMBER: MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: �Q�¢'L 10�!Zr' LICENSE NUMBER; rPlPlf'Z' 10'7. �o Lq, PHONE NUMBER: MAILING ADDRESS: l z (Street) (City/State)(Zip) MECHANICAL WORKSHEET/FEE DESCRIPTION SCHEDULE OF�tJNITS XITNNIITH AMOUNT DUCTWORK SYSTEM-_ - _ WOODSTOVE/INSERT - _ _ - - - _ GAS WATER HEATER _ _ _ HEATING EQUIPMENT <100,000 BTU �' _ _ _ _ HEATING EQUIPMENT +1001000 BTU GAS PIPING (EA OUTLET) _ _ _ _ - - _ _ _,, REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) REFRIG 101-500M BTU__ � REFRIG 501-1,OOOM BTU_ _ _ _ _ _ REFRIG 1,001-1,750M BTU_ _,,, - REFRIG +1,750M BTU _ _ _ _ _ - HEAT PUMP & AIR CONDITIONER 0-3. TONS HEAT PUMP & AIR CONDITIONER 3-1.5 TONS HEAT PUMP & AIR CONDITIONER 15-30 TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS _T HEAT 'PUMP ;& AIR CONDITIONER +50 TONS _ VENTILATING FANSx EVAPORATIVE COOLERS _ _- - - _ _- -- - _- -_ TYPE _I HOOD (PER 12T OR 12' PTN._ OF�HOOD)' TYPE II HOODx CLOTHES DRYERa -_ _ _- _- _- - - - -_ RANGE_-- -- - - --- - - - -_- GAS LOG MISCELLANEOUS (NOT COVERED ELSEWHERE)_'_ UNLISTED GAS APPLIANCE <400,000 BTU- _ _ UNLISTED GAS APPLIANCE >400,000 BTU_ _ _ USED APPLIANCE <400,j000 BTU- _ - _ _ ,,,,, _ USED APPLIANCE >400,000 BTU _- AIR HANDLER <10,000 CFM. - - _x AIR HANDLER >10,000 CFM - x$10.00 = x 25.00 = x 10.00 = x 12.00 x 15.00 x 1.00 = x 12.00 x20.00 x 25.00 = x 35.00 x 60.00 - x 12.00 = x 20.00 x 25.00 = x 35.00 x 60.00 10.00 = X 10.00 = x 50.00 10.00 = x 10.00 = X.10.00 = x 10.00 = X'10.00 = x 50.00 = x100.00 -= x 50.00 = x100.40 12.00 = x 15.00 - SUBTOTAL $ , PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT -54 b 0 NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE _ $ SIGNATURE Spokane County Department of Building and Safety ` West 1303 Broadway Avenue Spokane, WA 99260 (509) 456.-3675