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1993, 06-24 Permit App: 93005037 Mechanical Fixtures (2)35t31. Ol-tOq -PoL Lei ,P MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: N 1330 LILY /3-L5 7 CITY/STATE/ZIP: SPOKANE WA 99212 OWNER: HAROLD BROWN NAILING ADDRESS: E 11612 8th CONTRACTOR: PARCEL NUMBER: MONS NUMIBM: 928-2023 SPOK WA 99206 MAILING ADDRESS: ,(Street) -- (City/Btatm) (Zip) A&M QUALITY HEATING LICENSE NUMBER: Atiquammictum E 1 �'ii 1j31ANKAVE. SPOKANE; WA 99216 PHONE NUMBER: 92.1 -2 -too (Street) (City/State) (Zip) MECHANICAL WORKSHEET/YEESCH& HEDUL ORA& tJNIT5 MUltr DESCRIPTION DUCTWORK SYSTEM WOODSTOVE/INSERT GAS WATER HEATER HEATING EQUIPMENT 4100,000 BTU HEATING EQUIPMENT +100,000 BTU GAS PIPING (EA OUTLET). REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) REFRIG 101-500M BTU — —11111M .1.110 REFRIG 501-1,000M BTU REFRIG 1,001-1,750M BTU REFRIG +1,750M BTU HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER HEAT PUMP & AIR CONDITIONER VENTILATING FANS EVAPORATIVE COOLERS 0-3 TONS 3-15 TONS 15-30 TONS 30-50 TONS +50 TONS 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 NOTE: MIN P RMIT ,EE IS $35.00 SIGNATURE i �.� SUBTOTAL • AMOUNT •X$10.00 - x as.00 • x so..00 • x 12.00. . x 15.00 • x„ 1.00 . x12.00.09 x 20:00 - x 25.00.do 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 • PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT �� FEE DUE _ $ Spokane County Department of Buildin rand Safety West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675