1990, 05-16 Permit App: 90002113 Furnace, Piping MECHANICAL PERMIT APPLICATION FORM
•2nfOrmation Worksheet
JOB STREET ADDRESS: - // 2_-\_>4 L i i J/k y QG to
CITY/STATE/ZIP: / PARCEL NUMBER:
)
OWNER: I-lM k_ AO/S PHONE NUMBER:
MAILING ADDRESS:
(Stree ) (City/State) (Zip)
CONTRACTOR: i5 C- �/t� LICENSE NUMBER: SSEi21 /C51)3
-� /
PHONE NUMBER: P2 Jt -S '
MAILING ADDRESS: &[ /l}'
(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 x 12.00
HEATING EQUIPMENT +100,000 BTU -1 x 15.00 = 150-4
GAS PIPING (EA OUTLET) x 1.00 =
REFRIG 1-100M BTU (NOT A/C OR HEATPUMP) x 12.00
REFRIG 101-500M BTU x 20.00
REFRIG 501-1,000M BTU - r - 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
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 $ 0-0
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT} to 4/.0
NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE = $
SIGNATURE
Spokane County Department of Building_ and Safety
West 1303 Broadway Avenue Spokane, WA 9260 (5 9) 456-3675