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1990, 11-29 Permit App: 90006459 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM De f `- Information Worksheet p/ JOB STREET ADDRESS: I/ 64 G , )5-11/1 6S. CITY/STATE/ZIp: PARCEL NUMBER: S '3 [ ` OWNER: 1�1rf< �y(S PHONE NUMBER: c 14 7- / d MAILING ADDRESS: cove- (Street) (City/State) (Zip) CONTRACTOR: /- 1re_ Va)lQ y lT41, LICENSE NUMBER: ,e I/1J-L / t-// ©i/ iI fj Cali 05, J L " PHONE NUMBER: q -q _v v jc5) j MAILING ADDRESS: S O I N " E 1.C/1" �el SPo//a ria, /i/o. et 2_7 z_ (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 = /0 -0-e' HEATING EQUIPMENT <100,000 BTU x 12.00 = 1 o 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 = 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 $ 2-3 PLUS: PROCESSING FEE + $ 25. 00 EQUALS: TOTAL PERMITf ffb L,0 NOTE: MINIMUM PERM T- FEE IS $35.00 FEE DUE = $ SIGNATURE /141..%4alli VSpokane County Department of Building_ and Safety West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675