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1990, 04-16 Permit App: 90001488 Furnace, Piping MECHANICAL PIRMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: S. 2120 University CITY/STATE/ZIP: Spokane, Wa. 99206 PARCEL NUMBER: a J ' ` OS OWNER: Russ Benedict PHONE NUMBER: 926-3540 MAILING ADDRESS: 15223 4th Spokane, Wa. 99037 (Street) (City/State) (Zip) CONTRACTOR: Norco Heating & Air Cond. Inc. LICENSE NUMBER: NORCOHA170RZ PHONE NUMBER: 554-4975 MAILING ADDRESS: T, 5051 Tv nt Spnka.ne, Wa. 99212 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT = AMOUNT DUCTWORK SYSTEM x$10. 00 = WOODSTOVE/INSERT x 25. 00 = GAS WATER HEATER x 10. 00 = HEATING EQUIPMENT <100, 000 BTU 1 x 12. 00 = I2 0 HEATING EQUIPMENT +100, 000 BTU x 15. 00 = GAS PIPING (EA OUTLET) 1 x 1. 00 = 1 .UU 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 BTU 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 $ 13.00 PLUS: PROCESSING FEE + $ 25. 00 EQUALS : TOTAL PERMIT NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE = $ 38.00 SIGNATURE ��� /C ( 7 Spokane County Department of Buildin and Safety West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675