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1992, 10-01 Permit App: 92008270 Fireplace, PipingMECHANICAL PERMIT AP4LICATION FORM Information Worksheet JOB STREET ADDRESS: 3 LPP p (,19O8 -a9 nu CITY/STATE/ZIP: Spac 76'6 PARCEL NUMBER: OWNER: MAILING ADDRESS: S n0c; CONTRACTOR: PHONE NUMBER: /(.7 -e30 j (Street) a/11,700k, CAhlinMW MAILING ADDRESS: (City/State) (Zip) LICENSE NUMBER: PHONE NUMBER: (Street) l/4 -r ioe-s7007< 92Z -z000 (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH OF 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 1,001-1,750M BTU REFRIG +1,750M BTU HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & VENTILATING AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER FANS 0-3 TONS _ 3-15 TONS 15-30' TONS 30-50 TONS +50 TONS 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 = 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 20.0 x 25.00 x 35.00 x 60.00 x10.00 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 x10.0.00 x 12.00 x 15.00 NOTE:IMUM PERM IPQ EE IS $35.00 SIGNATURE " tt 6 Spokane CAunty Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 SUBTOTAL PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE