HomeMy WebLinkAbout1991, 10-17 Permit App: 91006901 Gas LogMEC33ANICAL PERMIT APPLICATION FORM
Information Worksheet��/�" " , / `Ji
JOB STREET ADDRESS: E. /3oo q i44-t"i1, L ,vw)`� �/7.10e9.1
CITY/STATE/ZIP:C, &!A PARCEL NUMBER: g1sf/ . -On
<41-64-±
���� 9 9a i�
OWNER. <1„ ^ • {- / f�--� PHONE NUMBER: 9a S 539Q
MAILING ADDRESS:�'O��
(Street)
(City/State) (Zip)
CONTRACTOR: A&M QUALITY HEATING LICENSE NUMBER: AMQj1AHF1991i1
E. 1 1triNPIANA 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.
DUCTWORX SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (EA OUTLET) it. ,Q. �HK��
REFRIG 1-100M BTU (NOT A/C OR. T PUM
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.-
x 12.00.=
x 15.00
X 1.00 =
X 12.00.-
x 20.00 -
x 25.00.=
x 35.00
x 60.00 a
x 12.00 =
x 20.00
x 25.00 =
x 35.00 a
x 60.00
x 10.00 =
x 10.00 a
x 50.00 -
x 10.00
x 10.00 a
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 =
10-00
NOTE: MIIji#U. ERMI� FEE IS $35.00
SIGNATURE
SUBTOTAL
$ �p00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 3 rob
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675