1990, 05-31 Permit App: 90002402 ACJOB STREET ADDRESS
CITY/STATE/ZIP:
MECHANICAL PERMIT APPLICATION FORM
Inforeatign Wprksheet
3z2/
OWNER: L01 61.1- '`"`""y
MAILING ADDRESS:
4/%19.44PARCEL NUMBER:
PHONE NUMBER: / vV.-/309
(Street)
CONTRACTOR: a.101,17)0/
(City/State) (Zip)
LICENSE NUMBER: /9.Grf Da.T '-/6'/3
PHONE NUMBER: 4917- 4‘.3.0.7?2
MAILING ADDRESS:
(Street)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT
(City/State) (Zip)
alen
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (EA OUTLET)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD -
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE)
UNLISTED GAS APPLIANCE <400,000 BTU
UNLISTED GAS APPLIANCE >400,000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM
I
= AMOUNT
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 1.00'=
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =,
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
/x•00
NOTE: MINIMUM PERMIT FEE IS $35.00
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 3 7,dd