1990, 12-11 Permit App 90005844 FurnaceDESCRIPTION
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS : G �L 130� y 2, i1.:My,
CITY/STATE/ZIP:4:26,tt2,11L/42(2..., PARCEL NUMBER: 1
OWNER: i/,5I A' � PHONE NUMBER: 9 M c717,2.
MAILING ADDRESS: 5' , / `7/.30 / Neg/OaULIJ/. D ,�CI�i'C� Gthi ,
(Street) (City/State) (Zip)
CONTRACTOR:k& 2/ ( „/%� 6. LICENSE NUMBER: �f��%//4-4//0/T
PHONE NUMBER: 9a2 2c /,
MAILING ADDRESS: ie, ja2/ ///¢ 4).
(Street)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000
HEATING EQUIPMENT +100,000
GAS PIPING (EA OUTLET)
REFRIG 1-100M BTU (NOT A/C
REFRIG 101-500M BTU
BTU
BTU
OR HEAT PUMP)
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
0-3 TONS _
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
TYPE I HOOD (PER 12' OR 12'
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
PTN. OF HOOD)
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
= 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 12.00
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 =
/S.Oo
/.4D
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Department of Building_ and Safety
West 1303 Broadway Avenue Spokane. WA 99260 (5091 456-3675