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1990, 10-01 Permit App: 90005066 Furnace, Piping • MECHANICAL PERMIT APPLICATION FORM ; i� Information Worksheet ; J , 1 JOB STREET ADDRESS: //�6 /i �- /..37/./ /-1O'e'� � CITY/STATE/ZIP: )C1CCL>L( uta 98/G' PARCEL NUMBER: (.`" OWNER: DO/G 1/ /6(1/i./[4 PHONE NUMBER: q `/ 63 g C•" MAILING ADDRESS: 60,-2-7-u _ - (Street) (City/State) (Zip) CONTRACTOR: /--2//21 7J(Jl y l#, j ('601(/0( LICENSE NUMBER:// 1 V/1 1 /S//G'H r/ // PHONE NUMBER: .9„2v DD/ MAILING ADDRESS: A/, 2/ �//AJ /eC/ .look7eif a.)G. 97,..)/...._ (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 = /2O O' HEATING EQUIPMENT +100,000 BTU x 15.00 GAS PIPING (EA OUTLET) / x 1.00 = / • e--O 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, 000 000 BTU x100.00; = AIR HANDLER <10,000 x 12.00 AIR HANDLER >10,000 CFM X 15.00 SUBTOTAL - $ . :to O . . PLUS: PROCESSING PEE + $ 25.00 EQUALS: TOTAL PERMIT ' NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE $ 31,E SIGNATURE Spokane County Department of Building_ and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675