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1991, 11-19 Permit App: 91007964 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM �I�nformation Work heet JOB STREET ADDRESS: .��'`4 -U�(.`t/ CITY/STATE/ZIP: ZIP� : � G%A 990/I�ARCEL NUMBER: OWNER: ea-- MAILING ADDRESS: CONTRACTOR: PHONE NUMBER: 9a - 4.57/17 (Street) A&M QUALITY HEATING E. 10TQTNDIANA AVE. SPOKANE, WA 99216 MAILING ADDRESS: (City/State) (Zip) LICENSE NUMBER: AMQIAHRIQIN1 PHONE NUMBER: (Street) 978-2100 (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH OF UNITS UNIT DESCRIPTION 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 HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & VENTILATING AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER FANS 0-3 TONS 3-15 TONS 15-30 TONS 30-50 TONS +50 TONS EVAPORATIVE COOLERS TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE II HOOD CLOTHES DRYER RANGE CAS 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 3 a 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 a X 12.00 = x 15.00 = ((J, OD d .00 9 00 NOTE: 1 GNATU 1t 1. MINIM PERMIT S $75.00 SUBTOTAL $ 25 o o PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ 50.00 Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675