1993, 04-09 Permit App: 93002361 Mechanical Fixturest,\,2_(;\‘ 1,61`i
G,h�s�cr2 dA 1 ULs
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JOB STREET ADDRESS:
CITY/STATES/ZIIP:
OWNER: /JIXJu
*o)° 9-3 - a 3 f
MECHANICAL, PERMIT APPLICATION FORM •
Information Worksheet
&-caL to/7a n)
!dl A 996, PARCEL NUMBER: 71°7
PHONE NUMBER: 9.2g-
MAILING ADDRESS:
,(Street)
(City/State) (Zip)
CONTRACTOR: A&M QUALITY HEATING LICENSE NUMBER:
E.10itrND)ANA AVE.
SPOKANE; WA 99216
MAILING ADDRESS:
M401AHR1 QIN1
PHONE NUMBER: 998-2100
(Street)
(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
0-3 TONS
3-15 TONS
15-10 TONS
30-50 TONS
+50 TONS
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
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
- 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 -
/0.'00
15, 00
•00
NOTE: MINIMUM PERMIT FEE, IS $35.00
SIGNATURE G�)
•
SUBTOTAL
$ X700
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE = $ Sa 0 6
Spokane County Department of Building"and Safety
West 1303 Broadwav Avenue Spokane, WA 99260 (509) 456-3675