1990, 08-21 Permit App: 90004067 Furnace, PipingOPT( C)C5
MECHANICAL PERMIT APPLICATION FORT /
Infarmation Worksheet
JOB STREET ADDRESS:
"77/.2 b 7/ (/GtJil (/
CITY/STATE/ZIP: PARCEL NUMBER: t LJ/i J - e)'1
OWNER: -.7v es
PHONE NUMBER:
MAILING ADDRESS:
(Street), (City/State) (Zip)
LICENSE NUMBER: 47...2-/e A017 / L/ / J P
PHONE NUMBER: 4/T477 -7/5"f
CONTRACTOR: A/0 ,a r Thj e -
MAILING ADDRESS: F % (Street) ) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
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 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR 'CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP.& AIR CONDITIONER
HEAT PUMP'& AIR CONDITIONER
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12'
TYPE II HOOD
0-3. TONS
3 -15, -TONS.
15-30 TONS
30-50 TONS
+50 TONS:.
OR 12' PTN. OF HOOD)
CLOTHES DRYER
RANGE
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
= AMOUNT
x$?0.00 =
x 25.00 =
x 10.00 =
x 12.00=
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 =
NOTE: IMUMM 'P RMI FE IS $35.00
SIGNATUR�
i G4
SUBTOTAL
$ /3
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 9260 (5 .9) 456-3675