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1990, 05-30 Permit App: 90002398 Furnace MECHANICAL PERMIT APPLICATION FORM -IA 2 u Information Worksheet JOB STREET ADDRESS: 6 1 I u .i 1 \ '4 A i - CITY/STATE/ZIP: •.;r 'j et,k)(r, PARCEL NUMBER: '�S J`- ``f - 0/ a OWNER: R t7l, 0\(CI V)e;.,---t PHONE NUMBER: 9 a rc - 8 4 MAILING ADDRESS: ..' elr,Il*...1 JxzitilN __.- (Street) i , (City/State) (Zip) CONTRACTOR: l 'N '� N ►4 l k LICENSE NUMBER:G. I,NI C._ f l cc_ PHONE NUMBER: ;)"2, ; --- 2 MAILING ADDRESS: 1 i c) a,.2, -- : i '‘` A..;.E . �� C (A t ci9 a)3 (Street) (City/State (Zip) ( P) 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 = / -rata HEATING EQUIPMENT +100, 000 BTU x 15. 00 = GAS PIPING (1 - 4 OUTLETS) x 4. 00 = GAS PI?ING (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 1,IN. OF HOOD) A ✓V 5n• V V 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 $ Ig_Ot) PLUS: PROCESSING FEE + $ 25. 00 EQUALS: TOTAL PERMIT NOTE: MNI UM (P • I i FEE IS 9FEE DUE = $ 37.06 SIGNATURE ',I- 1 %1p 1-- - Spokane C I , ty [Apartment of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675