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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