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1990, 11-01 Permit App 90005845 Furnace
MECHANICAL PERK T ArPL1CATION FORM:' Information Worksheet. JOB STREET ADDRESS: CITY/STATE/ZIP:. onaAra,Z OWNER: £ YJ zi j7 &#M& ig PHONE NUMBER: ' 7 /$2 7 `- 9 .P3s1a MAILING ADDRESS: 4/. /4I 3 ,.! /C"11 j' Geld 9? / (Street) (City/State) :' ,: (Zip) CONTRACTOR: Aat LVLUL / 219-/�`o LICENSE NUMBER: /g/4 f.Z/OIY 4 PHONE NUMBER: 95/a 0 f MAILING ADDRESS: %/. . / SW/9 . (Street) MECHANICAL WORKSHEET/FEE-SCHEDULE NUMBER X EACH, DESCRIPTION OF UNITS .UNIT. DUCTWORK SYSTEM WOODSTOVE/INSERT GAS WATER HEATER HEATING EQUIPMENT <100,000 BTU HEATING EQUIPMENT +100,000 BTU GAS PIPING (EA OUTLET) REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) REFRIG 101-500M BTU REFRIG 501-1,000M BTU REFRIG 1,001-1,750M BTU REFRIG +1,750M BTU HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP &. HEAT PUMP & VENTILATING AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR -CONDITIONER FANS 0-3 TONS 3-15 TONS 15-30 TONS 30-50 TONS +50 TONS, EVAPORATIVE COOLERS TYPE I HOOD (PER 12' OR 12' PTN. OF' HOOD) TYPE II HOOD CLOTHES DRYER RANGE GAS LOG MISCELLANEOUS (NOT COVERED ELSEWHERE)_ UNLISTED GAS APPLIANCE <400,000 BTU_ _ UNLISTED GAS APPLIANCE >400,000 BTU_ _ USED APPLIANCE <400,000 BTU USED APPLIANCE >400,000 BTU ..AIR HANDLER <10,000 CFM AIR HANDLER >10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00': SIGNATURE SUBTOTAL` x$10.00 x 25.00 x 10.00= x 12.00 = x 15.00 x 1.00 x 12.00 = x20.00= x 25.00 = x 35.00 = x 60.00 x 12.00 x 20.00 = x25.00 x 35.00 = x 60.00. = x-_10.00:.= x 10.00 = x 50.00 x 10.00 x:10.00. x:10 00 x '10.00 x 10.00 x 50.00 x100.00 = x 50.00 = x100.00 = x •12.00 = x.: 15.00 = PLUS: PROCESSING'FEE EQUALS: TOTAL PERMIT FEE' DUE Spokane County Department of Building_ and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 AMOUNT.