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1990, 09-28 Permit App: 90004978 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM 2'5-%a - ©--ol'_ 0 , Iriformation Worksheet - 6 ' JOB STREET ADDRESS: i /7,; (96 (hAe� _. G� ; .., & '$) CITY/STATE/ZIP: C_.,14 4 6,0 19016 NUMBER: /(_c / - 43 -/ OWNER: T © )2 \Jr i PHONE NUMBER: q,a - S c.),/ rN MAILING ADDRESS: Ad. /(00(0 V %,� z. / (44- C1g*-/ % 8'` Street) (City/State) (Zip) ` CONTRACTOR: f )&//-6-K LICENSE NUMBER: - --&-e___ 3 7 A)/ PHONE NUMBER: 47sq - //17O Y34/ MAILING ADDRESS: /9 3 7i 7 YIl %pt.(/ ` /3 9g 00 (Street) r (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 = /, OU HEATING EQUIPMENT +100, 000 BTU x 1 .9.,S _ GAS PIPING (1 - Y 4 OUTLETS) / x .4-.-0-0-- - / , ©C) GAS PIRING (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 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 BTUx10. 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 $ /3 61° PLUS: PROCESSING FEE + $ 25. 00 EQUALS: TOTAL PERMIT _-2 NOTE:_ M I PE T FEE IS $35. 0 FEE DUE $ --X�" " SIGNATURE O1 tet �! / - ' f Spokane Coun I 'partment of Building and Safety West 1303 Broadway Avenue Spokane. WA 99260 (5091 456-3675