1994, 09-13 Permit App: 94008892 Furnace MECHANICAL PERMIT APPLICATION FORM
. ....
Information Worksheet i --- 74% V47
JOB STREET ADDRESS:
CITY/STATE/ZIP: j`1 i,,,., ..l 21 ', 7 y.0/j PARCEL NUMBER:
OWNER:/Y)A1,,,1 t itiniv �,� jn ,/ ( PHONE NUMBER: S" _`1 a� /
MAILING ADDRESS: l
(Street) , (City/State) C (Zip)
CONTRACTOR: J\.i j-��zt-- k��•vrc ,�s LICENSE NUMBER:JV1) kCa 11,4 0 1 6 1, I
d' / PHONE NUMBER: ri =5 )1-1,/ lc-;
r
MAILING ADDRESS: :5/o ? J �ra.n t" _ ,�- , _ -j
9 4 /
(Street) (City/Sta �,�te) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT =AMOUNT
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 =
WOODSTOVE/INSERT.k
......>.:. ..... .... ............. ;::..... . ;>. x 25.00 =
GAS WATER HEATER x 10.00 =
:GAS EQUIPMENT�4100,000BTU(INCLUDES
/ x 12.00 = /j, 0
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
GAS:PIPING i�EA OUYL X 1.00 =
BOILER/REFRIG 1-100M BTU x 12.00 =
BOILER/REFRIG101- SOOM:BTU x 20.00 =
BOILER/REFRIG 601-1,000M BTU x 25.00 -
BOILERIREFRIG.1,000`t-1,750M BTU x 35.00 as
BOILER/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 15430 TONS x 25.00 =
HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 in
HEAT PUMP&AIR CONDITIONER 50 TONS x 60.00
VENTILATING FANS x 10.00 =
EVAPORAT•IVE 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 I.
MISCELLANEOUS(NOT COVERED ELSEWHERE: x1.0.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
:ULINSTED GAS APPLIANCE>400,000 BTU x100.00 I. _
USED APPLIANCE<400,000 BTU x 50.00 =
USED APPLIANCE x400,000 BTU x100.00 =
AIR HANDLER<10,000 CFM x 12.00 =
:AIR.HANDLER>1:0,000 CFM x 15.00 =
SUBTOTAL $ 1'h:7:I
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE $_3---). 00
SIGNATURE
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Spokane County Division of Buildings
West 131 'way Avenue Spokane, WA 99260 (509) 456-3675