1993, 04-08 Permit App: 93002288 Water Heater, Piping,\°tl.o2•.\
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c� /CAI
-2- MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS:
:ft J o a
CITY/STATE/ZIP: 9Q�90006 PARCEL NUMBER:
OWNER: 11/1}-u ii4A,t/t'Q - - PHONE NUMBER: 9023 -iia 7
MAILING ADDRESS:
(street) (City/State) (zip)
CONTRACTOR: A&M QUALITY HEATING LICENSE NUMBER: AMO)AHRIWIN1
E.101o1NDIANA AVE. PHONE NUMBER: 928-2100
SPOKANE; WA 99216
MAILING ADDRESS:
(Street)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE •
•
NUMBER X EACH
DESCRIPTION OF UNITS UNIT.
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
AMOUNT
X$10.00 -
x 25.00 -
x 10.00 r
X 12.00.,
x 15.00 a
X 1.00-
x 12.00.-
x 20.00 -
x 25.00.-
x 35.00 c
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
1U.Y1n
/,00
NOTE: IT EE IS $35.00
SIGNATURE
SUBTOTAL
/,00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= s 36,019
Spokane County Department of Buildinl�and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675