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1991, 07-22 Permit App: 91004385 AC MECHANICAL PERMIT APPLICATIONFORM / '- Information Worksheet 31 c-/ • JOB STREET ADDRESS: / 3/ 4 Com` 01•�� -- �i PARCEL NUMBER: c2/---/Y.3 - 07� a CITY/STATE/ZIP:� ��.r� a i � qq add 9 , IQaki_Q,W PHONE NUMBER: 9,9e0 - 5 5-93-- R OWNER: stutriI �} MAILING ADDRE / / 3 to 5 - ,tz-e I q9O� (Street) ( /State) (Zip) CONTRACTOR:) £'}c4 / 8U} LICENSE NUMBER: $E - Cz--tfx-37zAJr /� PHONE NUMBER: 418g -//76-) X 34194 MAILING ADDRESS: PD A a'7 07 , �t,' , WO . 99 ao (Street) City/State) (Zip) A 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 (1 - 4 OUTLETS) x /' ' - 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 = /a ' 0 0 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 I $ /o! ,o0 PLUS : PROCESSING FEE + $ 25 . 00 EQUALS: TOTAL PERMIT~ ©a NOTE: IN Mi AN6 T -FEEIS $35. 00 FEE DUE = $ 37, SIGNATURE a l�/+ t / _ a / rd Spokane Cou 'i epartment of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675