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1991, 05-03 Permit App: 91002305 ACJOB STREET ADDRESS: "MECHANICAL PERI' ASPLICATION FORM Information Worksheet SGS/ z' CITY/STATE/ZIP:&.94(- 7/Z PARCEL NUMBER: PHONE NUMBER: 3---55‘-'- 990-„R OWNER: MAILING ADDRESS: (Street) CONTRACTOR: AIR DESIGN, INC. f R21-99 aim (Cit /State) (Zip) LICENSE NUMBER: AIRDEI*161JW PHONE NUMBER: 487-4328 MAILING ADDRESS: E 1815 FRANCIS SPOKANE WA 99207 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH OI'" UNITS UNIT DESCRIPTION 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 1,00171,750M 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 EVAPORATIVE AIR'CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER FANS 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 = •Ov NOTE: MINIMUM PERMIT FEE IS $35.00 C-1/ 044C-ta SIGNATURE SUBTOTAL PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ .37• o c) Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675