1993, 01-14 Permit App: 93000155 Mechanical Fixtures3c5CW
2.p cP
JOB STREET ADDRESS:
CITY/STATE/ZIP:
OWNER:
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
AAntiL a s 9
G(%A 9 9a /A PARCEL NUMBER:
PHONE NUMBERS 9a S- 9 9 .7
(13-155
zoo
MAILING ADDRESS:
(Street)
CONTRACTOR: A&M QUALITY HEATING
CiOttriNDIANKAVE.
SPOKANE; WA 99216
MAILING ADDRESS:
(City/Stats) (Zip)
LICENSE NUMBER: AMQUAH 1O1N1
PHONE NUMBER: 928-240
(Street)
(City/Stat.) (Zip)
MECHANICAL
DESCRIPTION
WORKSHEET/FEE SCHEDULE
ONUMBERIEUNITx
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
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
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
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
..
• 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 is
1 ,t2O
NOTE: MIy MUM PERM E IS $�S.00
SIGNATURE i %I I/. L,/%r �-��
Spokane county Department of Building"and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
SUBTOTAL
$ 4. co
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE = $ L/ 9.0