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1990, 09-13 Permit App: 90004571 Furnace Ar 'vs MECHANICAL PERMIT,APPLICATION FORM Information Worksheet JOB STREET ADDRESS: / J/I C%•.+ ' f CITY/STATE/ZIP: S )Dxr)1) PARCEL NUMBER: 5-`1? Q� r C -,Pp l`7- f ✓A� F,l ' -9i OWNER: J i t r, 1)/�� PHONE NUMBER: MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: crN' \c.1lko,\I r,y 4-1 1C_ LICENSE NUMBER: S.\'k=+ - c \ 0 KF PHONE NUMBER: 922-2034 MAILING ADDRESS• 2206 N. Pines Rc . Spo':ane, WA 99206 • (Street) (City/State) (Zip) hELHAJr ICAL WORKSHEET/i'EE 6cHEDULE 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 = 12 . 00 HEATING EQUIPMENT +100, 000 BTU x 15. 00 = GAS PIPING (1 - 4 OUTLETS) 1 x 4 . 00 = 2.5 .00 GAS PIING (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 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 $ 16 . 00 PLUS: PROCESSING FEE + $ 25. 00 EQUALS: TOTAL PERMIT NOTE: MINIMFM P RMIT FEE IS $35.00 FEE DUE _ $ 41 . 00 SIGNATURE Thk , Spokane CountyDepartment of Building and Safety West 1303 BroadwaAvnue Spokane, WA 99260 (509) 456-3675