1991, 03-04 Permit App: 91000861 Range, Piping MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: /e6-72* , /.5 0- F6/
CITY/STATE/ZIP: PARCEL NUMBER:
OWNER: 4.6c Twz�� PHONE NUMBER: 9` 4 -
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MAILING ADDRESS:
(Street) (City/State) (Zip)
AIRE VALLEY
CONTRACTOR: HEATING & COOLING, ( SENSE NUMBER: /7/i?. 1, /%Z iy//) //
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N. 521 ELLA RD. PHONE NUMBER: cY? '--- ()O/?
SPOKANE, WA 99212
MAILING ADDRESS:
(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 =
HEATING EQUIPMENT +100,000 BTU x 15.00 =
GAS PIPING (EA OUTLET) / 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 =
I ; 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 $ /
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT
NOTE: MINIMUM PERMIT FEE IS $35. 00 FEE DUE = $ S
SIGNATURE
Spokane County Department of Building_ and Safety
West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675