1991, 09-20 Permit App: 91006120 Piping MECHANICAL 'PERMIT APPLICATION FORM
/{ A Information� Worksheet/
JOB STREET ADDRESS: /141 -4)%t Y/`a )
CITY/STATE/ZIP:• wA q9.2/‘)PARCEL NUMBER:
OWNER: aLtaAAL / i 1 /f/ 4 / �PH�ON/E NUMBER: 9a 7 - 02 790
MAILING ADDRESS: 4L4 �L`�7/'�
(Street) (City/State) (Zit)
CONTRACTOR: ; & Ni GE,71 fir. .lag w e� 4- LICENSE NUMBER: AMQUANF:193N1
E. 12710 InJ aiia PHONE NUMBER: 928-2100
Spokane "r' '
MAILING ADDRESS:
(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 x 15.00 =
GAS PIPING (EA OUTLET) - I x 1.00 = /, p l)
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 $ 100 D
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT
NOTE: MINIMU PERMIT FEE S $35. 00 FEE DUE _
SIGNATURE_ i�11111111/I S: rtirir✓
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260} (509) 456-3675