1990, 07-17 Permit App: 90003353 Heat Pump MECHANICAL PERMIT APPLICATION FORM
/J pInforma/tion, Worksheet
JOB STREET ADDRESS: i /`-4Dr ) /lG1I! I
CITY/STATE/ZIP:S f C)f�L(fO W(1 PARCEL NUMBER: U ` �' l 6 (. 6
OWNER: 11V02,04 �.`II(l�(^ PHONE NUMBER:
MAILING ADDRESS:
(Stre t) (City/State) (Zip)
CONTRACTOR:
14-1-1
I L i. «- k / LICENSE NUMBER:
KT«SP (Peic_)
'31114
PHONE NUMB R: ' i / _ est
MAILING ADDRESS: • S12 WPk'LOJJ( ) Ie fl& 0 I l e 1,141
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
1 NUMBER 1 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 x 15.00 =
GAS PIPING (1 - 4 OUTLETS) x 4. 00 =
GAS PIING (5 OR MORE. EACH: ) x 1. 00 =
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) 1 x 12.00 = j,•QO
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 $ ( ,(0
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT
NOTE* / �IMI . ' /FE : $3 .00 FEE DUE _ $ 37,00
SIGNA UR _ _lip ,
Spokane C i unty Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675