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1989, 07-17 Permit App: 89002228 Piping
MECHANICAL PER'JIIT APPLICATION FORM Information Vorksheet JOB STREET ADDRESS: CITY/STATE/ZIP: Sfbk.4NP i)9 -/ ??12 PARCEL NUMBER: OWNER: iY)..A/(1 f/vi .S EA L.. PHONE NUMBER: 6-3S-- / h` MAILING ADDRESS: F l rl LJ 11-f S'y 'j t/7 /f i,,k}" 99r9/ (Street) (City/State) (Zip) CONTRACTOR: Arne :.) C-CJ JJ7r LICENSE NUMBER: PHONE NUMBER: 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 (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 ' 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 $ PLUS: PROCESSING FEE + $ 25 . 00 EQUALS: TOTAL PERMIT} NOTE: MINIMUM PERMIT FEE I $35. 00 FEE DUE = $ SIGNATURE -2e//k, Spokane County epartment of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675