1989, 06-13 Permit App: 89001729 ACJOB STREET ADDRESS:
CITY/STATE/ZIP:
MECHANICAL PERMIT APPLICATION FORM
Informa%ion Worksheet
S 1911 SIN RD
ALE WA 99037
OWNER: ROD SGINIEEM LLER
MAILING ADDRESS : S 1911 CCNKL N RD
CONTRACTOR:
PARCEL NUMBER:
PHONE NUMBER: 922-2021
,(Street)
AIR I1 1I 4 HEATING & REFRIGERATION
MAILING ADDRESS: E 1807 FRAWLS
VERADALE WA 99037
(City/State) (Zip)
LICENSE NUMBER: AIIU EI#161 JW
PHONE NUMBER: 487-4328
(Street)
MECHANICAL
DESCRIPTION
WORKSHEET/FEE
SPOKANE WA
99207
(City/State)
SCHEDULE
NUMBER
OF UNITS
X EACH
UNIT = AMOUNT
(Zip)
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIPING (5 OR MORE. EACH:)
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 0-3 TONS _
AIR CONDITIONER 3-15 TONS _
AIR CONDITIONER 15-30 TONS
AIR CONDITIONER 30-50 TONS
AIR CONDITIONER +50 TONS
- _
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
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 4.00
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 =
20.00
NOTE: mital9m PERMIT FEE I8 $35.00
SIGNATURE :,�f'�
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
SUBTOTAL
20.W
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
45.00