1992, 06-22 Permit App: 92004608 Mechanical Fixturescf-4005
MECHANICAL PERMIT APPLICATION FORM IonI
Information pWorkssJh�eet� /fes
JOB STREET ADDRESS:
cf /a36 / -cat/At-Al avuvc-`_
CITY/STATTEE/ZQIjP%: �J. ,n.t, 4)4 99a0CPARCEL NUMBER:
OWNER: &JJ? PHONE NUMBER: 9, S- 93 i 7
MAILING ADDRESS:
(Street)
CONTRACTOR: A&M QUALITY HEATING
E. 1'gi 'f$1NDIANA AVE.
SPOKANE; -WA 99216
MAILING ADDRESS:
(Street)
-- (City/State) (Zip)
LICENSE NUMBER: AmpAr:RI99Ni
PHONE NUMBER: 928-2100
MECHANICAL WORKSHEET/FEE
DESCRIPTION
DUCTWORK SYSTEM
WOOOSTOVE/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
15-30 TONS
30-50 TONS
+50 TONS
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
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
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
(City/State) (Zip)
SCHEDULE
OF UNITS XPWIT
x$10.00 -
x 25.00 -
T— 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 -
I
2
- AMOUNT
/O;D
/a,00
NOTE: MIINIMMUM ERMIT FEE IS $35.00
SIGNATURE V^y[15
- t�� Spokane County Department of Buildingiand Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
SUBTOTAL
$ aq, 00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT _p
FEE DUE _ $ 7 I O 0