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1989, 10-02 Permit App 89003713 Gas HeatingDESCRIPTION MECHANICAL -PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: C /D I o,s FAX- CITY/STATE/ZIP: Si, 444%47 OWNER: PARCEI NUMBER: PHONE NUMBER: 9ag"-- (./o Y MAILING ADDRESS: 47' , /0 q 0 5- ,�' SPa ka,427 . (City/State) (Zip) (Street) CONTRACTOR: 4140t725o»15 SNLb-T ,n Er,?L 99 Aob LICENSE NUMBER: sAI JW MZ- PHONE NUMBER: 9� - o ? a MAILING ADDRESS: l3903 TeEnlT ,q-VC, Vokr3,tiE, al,d/, 19/6 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH OF UNITS UNIT = AMOUNT DUCTWORK SYSTEM WOODSTOVE/INSERT GAS WATER HEATER HEATING EQUIPMENT <100,000 BTU HEATING EQUIPMENT +100,000 BTU TS) GAS PIING (5 OR MORE. EACH:) 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 & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER VENTILATING FANS EVAPORATIVE COOLERS TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE II HOOD CLCTHES DRYER RANGE GAS LOG 0-3 TONS 3-15 TONS 15-30 TONS 30-50 TONS +50 TONS MISCELLANEOUS (NOT COVERED ELSEWHERE) UNLISTED GAS APPLIANCE <400,000 BTU_ UNLISSTED 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 x$10.00 = x 25.00 = 10.00 12.00 15.00 4.00 1.00 12.00 20.00 25.00 35.00 60.00 12.00 20.00 25.00 35.00 60.00 10.00 10.00 50.00 10.00 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 NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE���aoj✓ Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 SUBTOTAL PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ 37. �