1991, 09-18 Permit App: 91006029 Furnace, Piping ' MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: EAST 7012 - 11th . AVENUE
CITY/STATE/ZIP: Spokane, Va . 99212 PARCEL NUMBER:
OWNER: JOHN HAMILTON PHONE NUMBER:
MAILING ADDRESS: East 7012 11th . Avenue Spokane , Wa . 99212
(Street) (City/State) (Zip)
CONTRACTOR: POWERS , INC . LICENSE NUMBER: POWER-343ME
PHONE NUMBER: ( 509) 535-7714
MAILING ADDRESS: East 6507 Mallon Avenue Spokane, Wa . 99212-1091
(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 one x 12.00 = 12 . 00
HEATING EQUIPMENT +100,000 BTU x 15.00 =
GAS PIPING (1 - 4 OUTLETS) one x 1.00 = 1 . 00
GAS PIVING (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 $ 13 . 00
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT
• NOTE: MI IMUM PE; irr IS $35.00 FEE DUE = $ 38 . 00
SIGNAT
po ane County Department of Building and Safety
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