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1989, 04-05 Permit App: 89000739 Furnace MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: - CITY/STATE/ZIP:c/'OKA,U 1 �)9 PARCEL NUMBER: i OWNER: /--/qR/2 ' ,'d PHONE NUMBER: MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: /V. c F/ '/24 /9 LICENSE NUMBER: A .ir.5'dOth.+, PHONE NUMBER: - MAILING ADDRESS: // /✓T /�O ' /L) /l9i (Street) (City/State) (Zip) 42, MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT = AMOUNT DUCTWORK SYSTEM x$ 6. 50 = WOODSTOVE/INSERT x 10. 00 = GAS WATER HEATER x 6. 50 = HEATING EQUIPMENT <100,000 BTU x 9. 00 = q, O° HEATING EQUIPMENT +100, 000 BTU x 11. 00 = GAS PIPING (EACH OUTLET: ) x . 50 = � REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 9 . 00 = REFRIG 101-500M BTU x 16. 50 = REFRIG 501-1, 000M BTU x 22 . 50 = REFRIG 1, 001-1,750M BTU x 33 . 50 = REFRIG +1,750M BTU x 56. 00 = HEAT PUMP & AIR CONDITIONER 0-3 TONS _ _ x 9 . 00 = HEAT PUMP & AIR CONDITIONER 3-15 TONS _ x 16. 50 = HEAT PUMP & AIR CONDITIONER 15-30 TONS x 22 . 50 = HEAT PUMP & AIR CONDITIONER 30-50 TONS _ x 33 . 50 = HEAT PUMP & AIR CONDITIONER +50 TONS _ _ x 56. 00 = VENTILATING FANS x 4 . 50 = EVAPORATIVE COOLERS x 6 . 50 = HOODS x 6. 50 = CLOTHES DRYER x 6. 50 RANGE x 6. 50 GAS LOG x 6 . 50 = UNLISTED GAS APPLIANCE x 20. 00 = AIR HANDLER - 10, 000 CFM x 9 . 00 = SUBTOTAL $ J, Wil' PLUS: PROCESSING FEE + $ 15 . 00 EQUALS: TOTAL PERMIT NOTE: MINIMUM PERMIT FEE IS $20.00 FEE DUE = $ Signature /L/ Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675