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1990, 11-13 Permit App: 90006095 Sump Pump plamvivqi -• [I oERMIT APPLICATION FORM S . Information Worksheet 10615 JOB STREET ADDRESS: J . ,,/ Z (A) lip kCITY/STATE/ZIP: „Sep 'c,�, .t (A.)/(-- /PARCEL NUMBER: e/.51/I- 256 OWNER' S0� . C OO PHONE NUMBER: MAILING ADDRESS: `I (Street) (City/State) (Zip) CONTRACTOR: (tea/l a h Obi b LICENSE NUMBER: W/11`./9 PA /O g K-S J3 PHONE NUMBER: 3z - L0 104- MAILING 4-4MAILING ADDRESS: GU‘ (,2_0 t� e v v+a s�okaH e , Wye °c12_O5 (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) 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 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 = 6 .bf� JtAwle Cavtisiev / SUBTOTAL $ PLUS: PROCESSING FEE + $ 25. 00 EQUALS : TOTAL PERMIT^ NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE = $3,00 SIGNATURE 72.0 VW1 �L. Spokane County Department of Buildingand Safety West 1303 Broadway Avenue Spokane, WA 260 (509) 456-3675