Loading...
1991, 09-16 Permit App: 91005833 Pellet Stove MECHANICAL PERMIT APPLICATION FORM Inforr> tion Worksheet JOB STREET ADDRESS: L", /„ 0 f? L /2, '=-' CITY/STATE/ZIP: C- ye% •? //c. PARCEL NUMBER: Z9C f OWNER: ,0- 74 o,q c!//' < L PHONE NUMBER: 2 S-3' 3`/ MAILING ADDRESS: L-. 7 'y 3'> G> �`'' /7--t",c �:�nr i9 � � 44.7a %9 /� (Street) (City/State) (Zip) CONTRACTOR: (Ip A <LICENSE NUMBER: _ PHONE NUMBER:Z .�-5 - � 3,-// - ?22 MAILING ADDRESS: �: ? / /C' S ' `� / c i e ,C,'6 737 "4-1-'237- Liz,- //p/, tAa)ct- (Street) (City/State) (Zip) ?OD `c0 U)oo aSZO J MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT = AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = WOODSTOVE/INSERT x 25.00 = GAS WATER HEATER x 10.00 = GAS EQUIPMENT<100,000 8TU'{INCLUDES x 12.00 = GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00.= GAS PIPING (EA OUTLET x 1.00 = BOILER/REFRIG 1-100M BTU x 12.00 = ' 8. 1LER O REF R/ Ri ..1 1 G 0 - ._ __.._ _ ....._......._...... .:............. x 20.00 BOILER/REFRIG 501-1,000M BTU x 25.00 = ;OILER/REFRIG 1,000 1,750M BTU <> X 35.00 = BOILER/REFRIG +1,750M BTU • x 60.00 = REATPUMP&-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 = : x 10.00 = TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = .: : ;.>:.<:>::::::: .:::::;: :;•:;::::::; 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 = ULINSTED GAS APPLIANCE>400,000 BTU x100.00 = USED APPLIANCE<400,000 BTU x 50.00 = USED ARPLIANCE>400,000 BTU . xl 00.00= AIR HANDLER<10,000 CFM • x 12.00 AIR HANDLER;>10,000 CFM • x 15.00 = SUBTOTAL $ PLUS: PROCESSING FEE + $ 25.00 NOTE: MINIMUM PERMIT FEE IS $35.00 EQUALS: TOTAL PERMIT FEE DUE _ $ SQ SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane. WA 99260 (5991 456-'1A75