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1991, 07-01 Permit App: 91003853 Furnace, Piping MECHANICAL PERMIT APPLICATION FORM l` -�f 1 r Information Worksheet JOB STREET ADDRESS:.�` ; ( c.� IL p +# ; Oi ,,} 1 CITY/STATE/ZIP: PARCEL NUMBER: &, 5: I -6 -') 8 . OWNER: V PHONE NUMBER: MAILING ADDRESS: ,iq_,4. fes' P/ '//-///T/ (Street) (City/State) (Zip CONTRACTOR: .:..� . ..... ._- ,.,.... . , ��"`�� K LICENSE NUMBER: _ PHONE NUMBER: ''�, .- 7 333 MAILING ADDRESS: -%' '= i-ry, ,� (Street) (City/ tate) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = W000STOVE/INSEBT = F Y:+`Y'''{Y}. .:L}y •.::::: ? iii::::•..:.: H ice:{. %: :: :ti;:?;;:::»>:-::.,...n.. x 25.00 - GAS WATER HEATER x 10.00 = GAS EQtJiPME <t w,. ,,. I��' :��ad�,��,.;�.� OL�C3�Si>r''>• ::><`�> x 12.00 = _ =� cr-� <. GAS EQUIPMENT+100,000 8TU DUCTWORK) x 15.00 = : wel :....... (�J.4:Y : ..kwAfp , x 1.00 — /,,, 0 V BOILERREFRIG 1-100M BTU C i:ii : ix 12.00 = .,+ BOILER BgP#3IG`f Oi 1 -m..n.:..�s,., ''. = - .-v.. } ,.... x20.00 BOILER/REFRIG 501-1,•000M BTU x 25.00 = .B: 0 .I.. 1 Oo BOILER/REFRIG +1,750M BTU x 60.00 = HEAT PU" IP&AIB CONDiTI}ONEI &3 TONS x 12.00 = HEAT PUMP &AIR CONDITIONER 3-15 TONS x 20.00 = HEAT PUMP &MR CONDITIONER 15-30 TONS. x 25.00 = HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 = - {HEA ` "U.M.FS&.AIB GONDITIOf�EIi 0 TONG >>>}>i > - x 60.00 = - . .........v::Tn•::.av:.v: ......... ....... ........v:4n....)n{Sif:: R ....:..,. ........:.:.:•:.:::�-. VENTILATING FANS x 10.00 = EVAPORATIVE COOLERS >>:::r�:<:<:>: :>:<::: »>:>:>:::<:»:>::> x 10.00 = TYPE I HOOD (PER 12' OR 12' PIN. OF HOOD) x 50.00 = iii:•i{!..v. } TYPE II H <::`;'::>:»>:>: : :... _....000 ::.:.....;:::::::<:>�; :�>;:>>::>::>°:°:: : ;:::� �: x 10.00 _ CLOTHES DRYER x 10.00 = µwig RANGE ......: ::::... x10.00 = GAS LOG x 10.00 = ISCEL MLANEOUS(NOTCOVERED ELSEWHERE: x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ULINSTED GAS APPLIANCE y400,00U BTU x100.00 = USED APPLIANCE<400,000•BTU x 50.00 = USED APPLIANCE>4OO«DAO TU .:.:.:....... x100.00 = AIR HANDLER<10,000 CPM • • • • x 12.00 = AIR HANDLER>1O,000CrM} ' x 15.00 = SUBTOTAL $ / . PLUS: PROCESSING FEE +$ 25.00 NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT FEE DUE =$ 3or- tiri SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675