Loading...
1990, 02-13 Permit App: 90000520 Furnace, Piping MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: \\\A\ •_?N CITY/STATE/ZIP:5U , _)1� )\ 9 c PARCEL NUMBER: OWNER: \\(-\,\..\\ ( c PHONE NUMBER: g -9 Z( '( MAILING ADDRESS: --\\`t\ (Street) (City/State) (Zip) CONTRACTOR: LICENSE NUMBER: PHONE NUMBER: l -`9 247C,i, MAILING ADDRESS: C-%1l7/O46` (( (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 = HEATING EQUIPMENT +100, 000 BTU r: 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 $ PLUS: PROCESSING FEE + $ 25. 00 EQUALS : TOTAL PERMIT NOTE: MINIMUM PERMIT FEE IS $35. 00 FEE DUE = $ SIGNATURE Spokane County Department of Buildingand Safety West 1303 Broadway Avenue Spokane, WA 260 (509) 456-3675