1990, 09-24 Permit App: 90004851 Furnace, Piping MEGfAWWUAL rt,xMU 1 AP?LWWA HUM PW sm
Information Worksheet
,
JOB STREET ADDRESS: 3S 159 tJ U,
CITY/STATE/ZIP: \.N'4R18---PARGEL NUMBER:
OWNER: C) PHONE NUMBER:
MAILING ADDRESS: v) k S-~ S-- Corr 4 ,1-104.
c. (Street) (City/State) (Zip)
CONTRACTOR: 4u S ENSE NUMBER: del e?-
PHONE NUMBER: 9.2-2_ --S'15-` -MAILING ADDRESS: Z 2 l ^
, ` ,(Street) (Cit /State) (Zip)
1
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION OFFUUNNITS EAC
= AMOUNT
DUCTWORK SYSTEM x$10.00 =
WOODSTOVE/INSERT x 25.00 =
GAS WATER HEATER x 10.00 =
HEATING EQUIPMENT <100,000 BTU t x 12.00 = 12-'44
HEATING EQUIPMENT +100,000 BTU x 15.00 =
GAS PIPING (1 - 4 OUTLETS) x 4.00 =
GAS PIVING (5 OR MORE. EACH: ) t x 1.00 = C.lio
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 = J
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 = "1'
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 $ 13 c
i
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT
NOTE: MINIMUM ERMIT FEE IS $35.00 FEE DUE = $ 3B-�-
SIGNATURE c,9i" R
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675