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1992, 10-13 Permit App: 92008816 Mechanical Fixtures
MECHANICAL PERMIT APPLICATION FORM ✓'1 Irformation Worksheet JOB STREET ADDRESS: l D /6 �� t CITY/STATE/ZIP: PARCEL NUMBER: aC • /POI OWNER: j /���j, . 6f) JyC_(r- PHONE NUMBER: 9c2g - 7C90 MAILING ADDRESS: /©gc� "f9P9 • (Streeet)�J City/State) �a (Zip) CONTRACTOR: /�,� -// :JG\ 1L�1�� , LICENSE NUMBER -/-i .-37.24/7- / PHONE NUMBER: si'', MAILING ADDRESS; 2r3/A- (Street) • / (City/State) (Zip) immituumiumtiom w. 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 r x 10. 00 = /Q,O7J HEATING EQUIPMENT <100,000 BTU // x 12.00 = tq , (JZ} HEATING EQUIPMENT +100,000 BTU x 1 GAS PIPING (1 4 OUTLETS) / xpe), GAS PIING (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 ' PIN. 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 $ .316D PLUS: PROCESSING FEE + $ 25. 00 EQUALS: TOTAL PERMIT $ NOTE: I ` IIM . ������ E 4. 35.00 FEE DUE = SIGNATU• /�/�// LLlI��1� / Spok• e !�nty Department of Building and Safety • West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675