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1991, 08-29 Permit App: 91005436 Furnace, Piping
MECHANICAL PERMIT .APPLICATION FORM Information Worksheet .) qi. - 441:' BEET ADDRESS: f q►V STATE/ZIP: A a C G („LC PARCEL NUMBER: qqq ';2 b ?.i$AiI 4i i PHONE NUMBER: �1fiit� R:`' I a,.-7 r ,!;PCLING ADD- SS: (Street) (City/State) (Zip) LICENSE NUMBER: ijro<_��1-T-4-Cc.:`,3f4A- ds" TRACTOR: rr//,, !/�y�,r) ti - HONE NUMBER: ` (jr/'`7(�ciL 4*' NG ADDRESS: E gq 1164OLL,L, ,-., 33i<0 &Q 1,07 (ficv(Street) (city/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE *t° NUMBER X EACH 4t DESCRIPTION OF UNITS UNIT = AMOUNT ,D I ORK SYSTEM x$10.00 = j140pDSTOVE/INSERT x 25.00 = ASFWATER HEATER x 10. 00 = !�4 ir, ING EQUIPMENT <1004000 BTU x 12.00 = t ,C . ,, 1.s .TING EQUIPMENT +100, x 15.00 =.000 BTU. i PIPING (EA OUTLET) `` x 1.00 =x 12.00 = 1 c cO a•. FRIG 1-100M BTU (NOT A/C OR HEAT PUMP) - FRIG 101-500M, BTU x 20.00 = $;, PRIG 501-1,000M BTU ? x 25.00 = 1 »; RIg °1,001-1 750M BTU x 35.00 r' 4• G +1,750M„8TU-,;` _ j _ _ - - :,, UMPx 60.00 = & 'AIR CONDITIONER 0-3 TONS"_ _ x 20.00 = +,t . *PUMP' &:AIR:CONDITIONER :3-15 TONS _ 4 T ,PUMP &, AIR,'CONDITIONER 15-30 TONS _ x 25.00 = 31 ,TyPUMP ;& AIR CONDITIONER 30-50 TONS _ x 35.00 = qT,;PUMP & AIR,."CONDITIONER +50 TONS; _ _ x 60.00 = ",. % ..;TILATING FANS , x 16.oo - x10.00 = :j PORATIVE COOLERS,�, PEI HOOD (PER 12' OR 12' PTN.° OF' _ HOOD) '4 PEix 10.00 = -II HOOD f `'3` THES DRYER x 10.00 = w . GE :. x 10.00 = x 10.00 GAS ;LOG x 10.0 0 = _ .,ISCELLANEOUS (NOT. COVERED ELSEWHERE)_ _ x 50.00 = _., , �1I;STED GAS• APPLIANCE.;,<400,000 BTU_ _ _ x100. 00 = JItISTED GAS; APPLIANCE •.>400,000 BTU__ _ _°� x 50.00 = �� EDZ�APPLIANCE °<400,OOO BTU , x100. 00 = , EDAPPLIANCE >400,000 BTU x 12 . 00 = ' '`'AIR HANDLER <16,000 CFM, x 15.00 = „ . ' IR HANDLER >10,000 CFM SUBTOTAL $ 0,09 ' i. f PLUS: PROCESSING FEE + $ 25. 00 ^ „� EQUALS: TOTAL PERMIT FEE DUE _ $ ,.r , , NOTE4. : MINIMUM"PE FEE IS $35.00 -� ,t-1GNA URE i y� n a C C-t r 3. , *4 of Building_ and Safety 'fir .- Sp o ane County Department p Broadway Avenue Spokane, WA 9260 (509) 456-3675 . � West 1303