1991, 09-17 Permit App: 91005952 Gas Log, PipingMEC47..
ANICAL PERMIT APPLICATION FORM 5052.
JOB STREET ADDRESS: le:Cr
CITY/STATE/ P. : ' ?qa 06, PARCEL NUMBER:
Information Worksheet
S_a&aa FeY-K 124
OWNER:
MAILING ADDRESS:
PHONE NUMBER:
(Street)
CONTRACTOR: A & M QUALITY HEATING. INC.
E. 12710 Indiana
. Spokane, Washingtci 99216
MAILING ADDRESS:
(City/State) (Zip)
LICENSE NUMBER: AMQIIAHF193N1
PHONE NUMBER: 928-2100
(Street)
(City/State) (Zip)
MECHANICAL
DESCRIPTION
WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT'<100,000 BTU.
HEATING EQUIPMENT;+100,000 BTU
GAS PIPING, (EA OUTLET).
REFRIGY1-100M 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
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
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 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 1500 =
[0 •0A
NOTE:
SIGNATURE
MINI
IT F. E IS $35.00
SUBTOTAL
$ _/'(_&d
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 36.0-0
Spokane County Department of Buildingand Safety
West 1303 Broadwav Avenue Spokane, WA 9260 (509) 456-3675