1991, 09-18 Permit App: 91006026 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: 4224 N . Vercler Rd .
CITY/STATE/ZIP: Spokane , WA 99216 PARCEL NUMBER:
OWNER: Terry & Marlene Thies PHONE NUMBER:
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: Allied Heating. Inc . LICENSE NUMBER: ALLIE :*200D4
PHONE NUMBER: 928-8252
MAILING ADDRESS: 9309 E . Trent Spokane , WA 99206
(Street) (City/State) (Zip)
mow
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 1 x 10.00 = lo. 00
HEATING EQUIPMENT <100,000 BTU 1 X 12.00 = )0, 0o
HEATING EQUIPMENT +100,000 BTU x 15. 00 =
GAS PIPING (EA OUTLET) x 1.00 = .2, 0a
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)_t _4* ►' ,X 10.80 =
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 $ 24 .00
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT
NOTE: MIN MUM PERMI/T,FEE IS $35.00 FEE DUE = $ 49 .00
SIGNATURE �� C l� c '�
Spokane County Department of Bulidin_�(q and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (5 9) 456-3675 •