1990, 03-05 Permit App 90000738 FurnaceDESCRIPTION
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
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
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
0-3 TONS _
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
JOB STREET
ADDRESS:
CITY/STATE/ZIP:
OWNER: J ri 5
MAILING ADDRESS:
CONTRACTOR:
MECHANICAL PERMIT APPLICATION FOAM
Information Worksheet
/D / a � / -/ k vas
oI«itlz t,a_ 99.7ar ' PARCEL NUMBER: 5//( I -des
01 (10-- r1 ''-
PHONE NUMBER: 9,2 ' /3 /
(Street)
LICENSE
PHONE
MAILING ADDRESS: !/ ?U /1 ft 77 17 1 0774„,s,
(Street)
(City/State) (Zip)
NUMBER: 1-1/2 F i)17Il4/DH
NUMBER: y� (/ O G / f
City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
= AMOUNT
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.0C =
x 20.00 =
x 25.00 =
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 =
l5as
NOTE: j1INIMUM PERMIT FEE IS $35.00
SIGNATURE .1 1 �_
SUBTOTAL
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
FEE DUE
+ $ 25.00
= $ y/. 00
okane Count Department of Building_and Safety
West 13 3 Broadway Avenue Spokane, WA 99260 (509) 456-3675