1991, 11-21 Permit App: 91008101 Mechanical Fixtures"5,-4-5- 14E17
elL oc 6 5 a-- MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: 119 N. Conklin Rd.
CITY/STATE/ZIP:Spokane, WA 99216 PARCEL NUMBER:
Guk.etk ,vim !3-44 r
OWNER: Mildred Willis
MAILING ADDRESS:11005 F. 23rq
CONTRACTOR:,
(Street)
Allied Heating, Inc.
MAILING ADDRESS: 9309 F TrPnt
PHONE NUMBER;
�Ols�n� Ina\ 9n7fA
(City/State) (Zip)
LICENSE NUMBER: ALLIEI*200D4
PHONE. NUMBER; 928-8252
(Street)
crnhana wa 997nA
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
I NUMBERX EACH
OF UNITS I 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 & 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
r
•
= 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 =
x25.00 =
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 1048 =
x50.0b=
x100.00 =
x 50.00 =
x100.00
x 12.00 =
x 15.00 =
/0,00
42.60
Oo
M PERMIT FEEB I8 $35.00 /
SUBTOTAL
PLUS: PROCESSING FEE
$ 2,ck�
$ 25.00
EQUAL$: TOTAL PERMIT
FEE DUE
Spokane County Department of Buildin and Safety
West 1303 Broadwav Avenue Spokane, WA 99260 . (509) 4564675
4.1141111116...