1992, 12-17 Permit App: 92011039 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
�,e . - }InformationWorksheet
Wor
/V �2 //0
JOB STREET ADDRESS: N/ /6 /6 r�
CITY/STAT/E/ZIP: , &A 99,216 PARCEL NUMBER:
OWNER: ( // JWA2LAI PHONE NUMBER: 9a), -30 9 /
MAILING ADDRES :
(Street)
CONTRACTOR: A&M QUALITY -HEATING
E. 1moi"*INDIANA AVE.
SPOKANE; WA 99216
MAILING ADDRESS:
(City/State) (Zip)
LICENSE NUMBER: smnANR191N1
PHONE NUMBER: 99B-2100
(Street)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION OFUUNITS xUNIITM
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
AIR CONDITIONER 0-3 TONS
AIR CONDITIONER 3-15 TONS
AIR CONDITIONER 15-30 TONS
AIR CONDITIONER 30-50 TONS
AIR CONDITIONER +50 TONS
FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
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
/.
2
AMOUNT
x610.00 -
x 25.00 a
X 10.00 a
X 12.00.a
X 15.00 a
X 1.00
X 12.00,-
x 20.00 a
X 25.00 .a
X 35.00 a
x 60.00 -
X 12.00 m
x 20.00
X 25.00
x 35.00 -
X 60.00 -
X 10.00 a
X 10.00 a
x 50.00 -
x 10.00 -
X 10.00 -
x 10.00 -
x 10.00
X 10.00
x 50.00
x100.00 a
x 50.00 a
X100.00 -
X 12.00 m
x 15.00 m
/Q. 00
/ALDO
oo
NOTE: MIN ERMI FEE IS $35.00
SIGNATURE /47
Spokane County Department of Buildinqfand Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
SUBTOTAL
$ aq.00
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE = $ 40.00