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1989, 08-31 Permit App: 89003141 Furnace MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: f ////c4 d / L 2 CITY/STATE/ZIP: //} 9cv PARCEL NUMBER: E ©2 OWNER: PHONE NUMBER: /e2--95 C/ � MAILING ADDRESS: ,:2 ,44c.(26 (Street) (City/State) (Zip) G2 9r) CONTRACTOR: / ,yf 3 `7 6210 LICENSE NUMBER: PHONE NUMBER: MAILING ADDRESS: (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 = 13. , o o HEATING EQUIPMENT +100,000 BTU x 15. 00 = GAS PIPING (1 - 4 OUTLETS) x 1,4/. 00 = p , 00 GAS PIPING (5 OR MORE. EACH: ) 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 30_ 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 $ T'3, O PLUS: PROCESSING FEE + $ 25. 00 EQUALS: TOTAL PERMIT NOTE: MINIMUM PERMI EE IS $35.00 FEE DUE _ $ a&.00 SIGNATURE Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675