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1992, 10-09 Permit App: 92008703 Mechanical FixturesJOB STREET ADDRESS: CITY/STATE/ZIP: c9 111034/0 -3S 4AA 9\ co MECHANICAL PERMIT APPLICATION FORM U\fr j -> 4Infnrmation Worksheet bia4-44.1 a 41/8 d� uJ!l /92/2 PARCEL NUMBER: A6 -117,Q_ ) 11) I OWNER: M2462 CradtteLl PHONE NUMBER: la v- q rig F' MAILING ADDRESS: (Street) A&M QUALITY HEATING E. 117TWINDIANA AVE. SPOKANE; WA 99216 MAILING ADDRESS: CONTRACTOR: (City/State) (Zip) LICENSE NUMBER: PHONE NUMBER: (Street) A)/0)IAHR 141N 1 928-2100 (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 AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER FANS HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & VENTILATING 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 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 / AMOUNT x$10.00 - x 25.00 - x 10.00 .- x KKKKKKKK 12. 15.00 - 1.00 - 12.00.- 20.00 - 25.00..- 35.00. - 60.00 - 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 oo NOTE: MI MUPERM,�IS $35.00 SIGNATURE SUBTOTAL s a'/o PLUS: PROCESSING FEE + $ 25.001 EQUALS: TOTAL PERMIT FEE DUE = $41g,0o j Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675