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. �