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1989, 10-04 Permit App: 89003721 Furnace MECHANICAL PERMIT Aa'PLICATION FORM Infornatit)n Worksheet JOB STREET ADDRESS: L- / 7/-)/7? y ,e--r S9_ 372/ CITY/STATE/ZIP: ,I, Z, ',, 7 l?-/ PARCEL NUMBER: lL/sN-- C302- OWNER: 3O2.OWNER: r%Y� . / _A�� 7 PHONE NUMBER: aid' --,52Fh MAILING ADDRESS: �, / /f - 1,e'-' 4 �=- (Street) (City/State) (Zip) CONTRACTOR: ./ rLZ/973.„,__ 6?, LICENSE NUMBER: ��X71)„L- ' /fin/J-e-� / PHONE NUMBER: MAILING ADDRESS: , /S2. - i �v,„e/,� Q'v /i _ / (Street) / (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION OF NUMBER ( X EACH 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 = , (,LC HEATING EQUIPMENT +100,000 BTU x 15. 00 = GAS PIPING (1 - 4 OUTLETS) x 4 . 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 , „. 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: I� PERMIT� IS $35.00 FEE DUE = $ `3'/,-�=' SIGNATURE �� - �/��" ; Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675