1991, 03-13 Permit App 91001060 Htg EquipDESCRIPTION
JOB STREET ADDRE S:
CITY/STATE/ZIP:
OWNER:
T y y
MAILING ADDRESS:
MECHANICAL PERMIT APPLICATION FD iI1
Informal.ioit -Wor sheet
o
// 3 2 - a aPY'y
Q�j�O, C)4. A'fZCE NUMBER:
(Street)
CONTRACTOR: M & i�L
E. Spef(ane,1l,,i� �,; r n q
MAILING ADDRESS:
LICENSE NUMBER:
PHONE NUMBER:
(Street)
PHONE NUMBER:
0-?.- 77/
(City/State) (Zip)
ri
.- -
�(',
?/- /oft
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
OF UNITS
X EACH
UNIT
DUCTWORK SYSTEM
WOODSTOVE/.TNSERT.
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:..
HEAT PUMP & AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS _
HEAT PUMP & AIR CONDITIONER 15-30 TONS
HEAT PUMP-& AIR' CONDITIONER 30-50_TONS
HEAT .PUMP .& AIR CONDITIONER +50 TONS
VENTILATING FANS
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
SIGN
NOTE: I UM P I�E IS $35.00
ATURE r 6�� Q
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 9 260 (509) 456-3675
= AMOUNT
x$!0.00 =
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 =
SUBTOTAL
$ /S.1
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
FEE DUE
t $ 25.00