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1989, 07-11 Permit App: 89002159 Water Heater MECHANICAL RERMLT APPLICATION FORM Information Worksheet 4 JOB STREET ADDRESS: .24 r k)00 CITY/STATE/ZIP: , � 9g22) (,, 5j PARCEL NUMBERUq'Ct -q00� OWNER: eit) ) PHONE NUMBER: GJ,"�' MAILING ADDRESS: J `7 `�J06b6 D ' c- (Street) (Street) (Ci y/S ate) (Zip) CONTRACTOR: 6ert , LICENSE NUMBER: PHONE NUMBER: 4 - // 70- e. , 3 MAILING ADDRESS: � ' E3'24i'7 (J GJ izu) Street State (Street) (CY/iy/ ) (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 = /0°° HEATING EQUIPMENT <100, 000 BTU x 12.00 = HEATING EQUIPMENT +100,000 BTU x 15. 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 $ /fit° PLUS: PROCESSING FEE + $ 25. 00 EQUALS: TOTAL PERMIT NOTE: MIN UM PERMIT, E IS $35.00 FEE DUE _ $ 35� SIGNATURE �1 - Spokane County De artment of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675