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1992, 08-19 Permit App: 92006606 Mechanical FixturesJOB STREET ADDRESS: CITY/STATE�/ZIP: OWNER: t� MECHANICAL PERMIT APPLICATION FORM Information Worksheet /15-4) A ALITVi 8�3 42A 9/2d6 PARCEL NUMBER: 14567- /rn MAILING ADDRESS: CONTRACTOR: PHONE NUMBER: (Street) -3349 (City/State) (Zip) A&M QUALITY HEATING LICENSE NUMBER: amlattmAs ll E i lirmx-AvE. SPOKANE, WA 99216 MAILING ADDRESS: PHONE NUMBER: 928-2100 (Street) (City/State) (Zip) MECHANICAL DESCRIPTION DUCTWORK SYSTEM WORKSHEET/FEE SCHEDULE OFUUNIITTS xUNIT 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 & 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' 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 • X$10.00 = X 25.00 = x 10.00= X 12.00.= X 15.00 is X 1.00 - X 12.00,. x 20.00 = 25.00.= 35.00 = 60.00 = 12.00 = 20.00 = 25.00 = 35.00 - 60.00 = 10.00 = 10.00 - 50.00 = 10.00 = 10.00 = 10.00 = 10.00 = 10.00 = 50.00 = x100.00 = X 50.00 = x100.00 = x 12.00 - x 15.00 = - AMOUNT D0 NOTE: M'IIIMUM PERMIT FEE IS, $35.00 SIGNATURE ` L/1, ) 41A.�' i�- SUBTOTAL PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ 0 0 Spokane County Department 'of Building"and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675