1993, 02-12 Permit App: 93000851 Mechanical Fixtures1-1 Pja-11-1. 1520 -
;I«c_cp_e37 ACEe5 Ind
MECHANICAL PERMIT APPLICATION FORM
LA /b -/v Ilinformation Worksheet
JOB STREET ADDRESS: .ad)i /3// idectkuil
CITY/STATE/ZIP: Cionn99.2/6 PARCEL NUMBER:
OWNER: 7e -d/.06641/142,4 PHONE NUMBER:
9,2F -Sy/ ap-Sp/
MAILING ADDRESS: �O3
cml)-3-3r5j
ate. a a
CONTRACTOR:
(Street)
(City/State) (Zip)
A&M QUALITY HEATING LICENSE NUMBER:
E. 10101Nb)ANA AVE.
SPOKANE; WA 99216
MAILING ADDRESS:_
(Street)
A)4QIIAHR l 9 1N 1
PHONE NUMBER: 998-2100
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION OFUUNITS XS
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
a
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 15.00 -
/0.00
/2.0n
,60
NOTE: MI
SIGNATURE
T, FEE IS $35.00
SUBTOTAL
S Alice
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Department of Building"and Safety
West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675