Loading...
1990, 01-05 Permit App: 90000079 Furnace, Piping MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: / (O /6-77Q CITY/STATE/ZIP: t.Fk5 Gc / S,4/ 9:g?/5 PARCEL NUMBER: OWNER: AL /A/6 // PHONE NUMBER: MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: A2%/j6p /4977,06 LICENSE NUMBER: /4U-/E/ acan,ay PHONE NUMBER: 9028-8'aS'� MAILING ADDRESS: r // 274Gwir. • 400 L49 (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 = /02, 00 HEATING EQUIPMENT +100,000 BTU x 15. 00 = GAS` PIPING (1 4 OUTLETS) tT ,° .:/ x 4 . 00 = 4, oo GAS PIVING (5 OR MORE. EACH_) r ° ' ' ` 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 $ /(. U4 PLUS: PROCESSING FEE + $ 25. 00 EQUALS: TOTAL PERMITf NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE = $ /00 SIGNATURE Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675