1989, 12-22 Permit App: 89005317 Heater MECHMIICkt. PERMIT APPLICATION FORM s'/
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Information Worksheet
JOB STREET ADDRESS: N. 2505 Wilbur Rd. `- i .(; L..,0 __ Q_ (A__) - _A_I__1-t '
CITY/STATE/ZIP: Spokane, Wa. 99206 PAR EL NUMBER: r'll_ fs
G�- �C -- 2.`. ic't
OWNER: Paul Milliken PH NE NUMBER: 924-8990 ---
MAILING ADDRESS: same as above
(Street) (City/State) (Zip)
CONTRACTOR: NOrco Heating & Air Cond. LIC NSE NUMBER: NORCOHA17ORZ
P ONE NUMBER: 534-4975
MAILING ADDRESS: E. 5051 Trent Spokane, Wa. 99212
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/ EE 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 1 x 15. 00 = 1 .00
GAS PIPING (1 - 4 OUTLETS) x 4 . 00 =
GAS PIING (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 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 $ 15.00
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT-
NOTE: MINIMUM PERMIT EE IS $35.00 FEE DUE = $ 40.00
SIGNATURE 9d,e,„ 4e.> _ i .�'Cep�t-q_�:�
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675