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1992, 01-06 Permit App: 92000063 Piping MECHANICAL PERMIT APPLICATION FORM InformationWorkshlet JOB STREET ADDRESS: R // b 9 '. -7 9 . CITY/STATE/ZIP:4 , PARCEL NUMBER: OWNER: -0 . PHONE NUMBER: A 4f MAILING ADDRESS: ,)41,--e,-A4_11._ (Street) (City/State) (Zip) CONTRACTOR: ( je t LICENSE NUMBER: ZJ) 4 77 /a/ c rr PHONE NUMBER: S3c---" 9 j MAILING ADDRESS: e,. .c� irr.. 46.01 >4.4wc,. l �a , (Street) (City/State) (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 = HEATING EQUIPMENT <100, 000 BTU x 12.00 = HEATING EQUIPMENT +100, 000 BTU x 15. 00 = GAS PIPING (EA OUTLET) 1 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 $ PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE = $ 4 � SIGNATURE`_/% Spokane Coun Department of Building and Safety West 1303 Broadway venue Spokane, WA 99260 (509) 456-3675