Loading...
1991, 08-26 Permit App 91005316 Furnace, Log, ACMECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: L-. • 1 w503 - 3 .0)RDl v/�� CITY/STATE/ZIP: , POkA�& tviq. 9 2 ((o PARCEL NUMBER: { OWNER:J-d14/\% �,�,( o O V5 PHONE NUMBER: G /, L' pC y MAILING ADDRESS: E. ! `-150.3 t Ql- JA7 lj. Pv. L,Uf . 216, (Street) (City/State) CONTRACTOR: Q) A L L T y HTT . LICENSE NUMBER: PHONE NUMBER: (Zip) MAILING ADDRESS: (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOVE/1NSER7 .............:.........:..::::..:.:......:..::......... GAS WATER HEATER ................. GAS: EQUIPMENT <10(,000 BTU' (INCLU...... GAS EQUIPMENT +100,000 BTU DUCTWORK) GAS;PIPING EA OUTL BOILER/REFRIG 1-100M BTU BOI ERIREFR G 1:0,1 00M BT ;.; BOILER/REFRIG 501-1,000M BTU BO(L ER/REFRIG 1 001 1 750M BTU» BOILER/REFRIG +1,750M BTU HEAT PUMP &: AIR CONDITIONER 0 3 TONS:;::.:;; HEAT PUMP & AIR CONDITIONER 3-15 TONS ...... ............ HEAT. PUMP & AIR CONDITIONER 15-30 T.ONS`::>' :: >: > HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMP &. AIR CONDITIONER:+50 TONS >> `' VENTILATING FANS APORATIVE 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 ULINSTED GAS APPLIANCE >400,000 BTU USED APPLIANCE <400,000 BTU USED.: APPLIANCE : 400,000 .BTU AIR HANDLER <10,000 CFM AIR HANDLER>10000:CFM NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATUR (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x 10.00 = x12.00 = 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 = x60.00 = / x 10.00 = x 10.00 = x 50.00 = x 10.00 = x 10.00 = x 10.00 = 1 x 10.00 = x 10.00 = x 50.00 = x100.00 = x 50.00 = x100.00 = x 12.00 = x 15.00 = SUBTOTAL $ PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675