1992, 11-13 Permit App: 92010034 Mechanical FixturesJOB STREET ADDRESS:
CITY/STATE/ZIP:
OWNER: Ja'n 2a
iiECaANICAL PERMIT APPLICATION FORM
InformaCion Worksheet
Ea 3 t /3063 , ct ui.' l2 - /60861
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t/VA 7 9.2/6 PARCEL NUMBER: /J (J
er -112J PHONE NUMBER: 9a D //�
MAILING ADDRESS:
CONTRACTOR:
(Street) - (City/State)
A&M QUALITY HEATING
E. 1f71b7NDIANAAVE.
SPOKANE, WA 99216
MAILING ADDRESS:
LICENSE NUMBER: AJIQIIAM? 199N1
PHONE NUMBER:
(Zip)
928-2100
(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
15-30 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 a
x 25.00
x 10.00
x 12.00.a
x 15.00 -
X 1.00 v
X 12.00.a
X 20.00 a
x 25.00.a
x 35.00 a
x 60.00 -
X 12.00 u
x 20.00 a
X 25.00
x 35.00 a
x 60.00
x 10.00
x 10.00 v
x 50.00 -
x 10.00
X 10.00 a
X 10.00
x 10.00 -
x 10.00 a
x 50.00
x100.00
x 50.00 m
x100.00 v
X 12.00 =
x 15.00
/0. 00
').0n
/O,n0
NOTE: M3NIIMUM PE T EE , S $35.00
SIGNATURE CQGI�i�r I r t
/
Spokane County Department of Buildingland Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
SUBTOTAL
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE = $ L%%00