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1990, 08-07 Permit App: 90003794 Water Heater MECHANICAL PERIVIITAPPLICATION FORM Information Worksheet JOB STREET ADDRESS: ''" . KC' : ---) -r.-:, Y..... `,-; CITY/STATE/ZIP: ' , - PARCEL NUMBER: OWNER: -- ':- C -tor- PHONE NUMBER: n"--- 1()-S .;-r). ^..-1,,, MAILING ADDRESS: ) -• J• 0- (Street) (City/State) (Zip) CONTRACTOR: 1-3700 e,ti_n, :- Kir '-orrl. LICENSE NUMBER: PHONE NUMBER: MAILING ADDRESS: tT," 51 . '1--c,ril, (Street) (City/State) (Zip) • . 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 = r.DO HEATING EQUIPMENT 100,000 BTU x 12.00 = HEATINGrEQUIPMENT-.+100,000-BTU-- ,- - - x 15.00 = , GAS PIPING ;(EkOUTLET) , . - .- . ' x 1.00 = REFRIG:17 03 (NOT A/C OR ELEN.r.,PUMP) . 1001C Tir x 12.00 = • REFRIG10159,0141.'BTUA- -0' ' .. - :.1. '.. ' x 20.00 = • REFRIG.:503:434.900W BTU-1,- -fr.,- • • x 25.00 = • - REFRIG ,l''601=4 750M,:•BTU .. ' . x 35.00 = REFRIG +1,1750M BTU.,%z !- x 60.00 = HEAT. PUMPAIR' CONDITIONER 0-3 TONS x 12.0C = - HEAT PUMPJL'AIWCONDITIONER -3-15 TONS x 20.00 = HEAT PUMP,:& AIR- CONDITIONER 15-30 -TONS x 25.00 = HEAT PUMPAIR CONDITIONER 30-50 TONS x 35.00 = HEAT PUMP Sc7AIR- 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 $ i' .n PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE = $ --; -T- SIGNATURE -,-:?:Z--k, Spokane County County Department of Building_ and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675