1990, 07-03 Permit App: 90003120 Mechanical Fixtures MECHANICAL PER14'IIT APPLICATION FORM
Informati ;n Worksheet
JOB STREET ADDRE=S: �, / 6 l -- , /5 j
CITY/STATE/ZI• •,k.of`;�_J, ,/ I ,ARCEL NUMBER: /.".
OWNER: (?% L44 - - PHONE NUMBE•'. "),-,1e-,.5,50-j._
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MAILING ADD• i S: l� ?/� y - /�� I " , , hJ, c A,
(Street) , City/Sta�) (Zip) •
CONTRACTOR:N, .. _. A01Q4. LICENSE NUMBER: 5L, e- 5A-437 A(7
PHONE NUMB'R: f?7 '//7O X(. 3-57,(
MAILING ADDRESS: `�D 15 J2D / �,,1 ' , b1L.
(Street) (City/State) (Zip)
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MECHANICAL WORKSHEET/FEE SCHEDULE
I 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 = /woe
HEATING EQUIPMENT +100,000 BTU x 1�
GAS PIPING (1 - 4 OUTLETS) / x = % o0
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 $ Xi ‘"2
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT} p
NOTE: NIMIIM PE ;T FEE IS $35.00 FEE DUE _ $ ye
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SIGNATURE __4(:„ ,4...4.01.
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675