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1990, 11-20 Permit App: 90006297 Mechanical Fixtures per4 414 // MEC}IANI CAL PERMIT APPLICATION FOR ,22.6.-/ Information Worksheet JOB STREET ADDRESS: /4/6 /w q )..{141 _02,3_5-K? D a.2D CITY/STATE/ZIP: !/QZGt dZ- i a},9 .,7, ',..3.7 PARCEL NUMBER: ,d o? /0 OWNER: inG['JZQ,J e ..[J'�1 PHONE NUMBER: 9q' 0 -l� MAILING ADDRESS: S.'1/00-1 c,N/..c -vt, //�4,Gt-dG21P_ _, 6(m-99037 (Street) (City/State) (Zip) CONTRACTOR: 0,40 7)6A. -L- LICENSE NUMBER:e - - j7 -4V/ PHONE NUMBER: L/41/2-//,V 1/__-- MAILING / MAILING ADDRESS: Po 3707 /_/_./_ sig. _� ,/ /mor. I (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 = /y:2. HEATING EQUIPMENT +100, 000 BTU x 15. 0 = 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 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 $ �0c'o , PLUS : PROCESSING FEE + $ 25 . 00 EQUALS: TOTAL PERMIT Q NOTE: INI UM-EO T FEE IS $35.00 FEE DUE _ $ �O° SIGNATURE �ti� � QQ� Spoka e dilunty Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675