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1990, 05-07 Permit App: 90001932 Mechanical Fixtures /3,? -- MECHANICAL PERMIT APPLICATION FORM Information//Worksheet JOB STREET ADDRESS: e., // ./' 7 4, ` CITY/STATE/ZIP: PARCEL NUMBER: 40 :)/5-e,/ _foto 4.4 OWNER: A�c�-2 Ola? PHONE NUMBER: bllj //1 MAI LING ADDRESS: "77 , 74:;;7"(-)/ `)/74,0---44.4t--42_ (Street) ty/State) (Zip) CONTRACTOR: P,„14-- LICENSE NUMBER: /9-1- . 1-2E11/6/-37-1-) PHONE NUMBER: MAILING ADDRESS: � � �i'e%C4z-Gc --�,- j4// 7 (Street) City/State) (Zip) IIMMEMME 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 = HEATING EQUIPMENT <100, 000 BTU / x 12. 00 = /a up HEATING EQUIPMENT +100, 000 BTU x 15. 00 = GAS PIPING (EA OUTLET) / x 1. 00 = / U v 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 $ /3. 0 PLUS: PROCESSING FEE + $ 25 . 00 EQUALS : TOTAL PERMIT NOTE: TOTAL $PERMIT FEE ��ISjJ$35. 00 FEE DUE = $ 3 . )d SIGNATURE Spokane County Department of Building_ and Safety West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675