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1989, 08-24 Permit App: 89002972 Furnace VECHANICAL PERMIT APPLICATION FORM I - �3 -`=!a Information Worksheet 1 6 4_ JOB STREET ADDRESS: - . /1-71-‘2(4,��11 ���0- PARCEL NBER: CITY/STATE/ZIP: /7 ) , ��- 6k qi2 .OWNER: t----? 1 '4 ..I I ' I PHONE NUMBER: /2.$1 -6/L MAILING ADDRESS: �� ( / / U J 11)e, ; 1 ' (Street) i-' (City/State) (Zip) CONTRACTOR: �a: :� ( i . LICENSE NUMBER: -C - - )-Jv1-/V 7L" L} PHONE NUMBER: `f�7-//20 -12)04 . -32 MAILING ADDRESS: Pe -Pa-, 3?0 G c• `�,)Cti �%7 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER I X EACH I 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 0-Aft., x 12.00 = 6?-4'9-- HEATING EQUIPMENT +100,000 BTU e x 15. 00 = -- GAS PIPING (1 - 4 OUTLETS) x 4 . 00 = GAS PIING (5 OR MORE. EACH: ) x 1. 00 = 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 HOODx 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 $ � "_ Icy PLUS: PROCESSING FEE + $ 25. 00 EQUALS: TOTAL PERMIT NOTE: MINIMUM PERM T FEE IS $35.00 FEE DUE = $ 6-7`2- �9.,n,, SIGNATURE C ( 0 .- . , z-/ Spokane County partment of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675