1992, 12-17 Permit App: 92011042 Mechanical FixturesJOB STREET ADDRESS:
CITY/STATE/-ZIP:
3-C
OWNER: ct 3G14Vl(4,e0e•)
MECHANICAL PERMIT APPLICATION
AN.. - Information Worksheet
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�ooD Pow t
FORM e!vL2/ ',
/0A 99a o (O PARCEL NUMBER:
MAILING ADDRESS:
CONTRACTOR:
PHONE NUMBER:
(Street)
A&M QUALITY -HEATING
E. 1 fi r8 JDiANA AVE.
SPOKANE; WA 99216
MAILING ADDRESS:
4ssog. /122 ./
(City/State) (Zip)
LICENSE NUMBER:
PHONE NUMBER:
(Street)
SMQJIAMY 7 9 9M 1
928-2100
(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
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
tn. 00
.00
.Q,o6
NOTE: MINI
SIGNATURE
IT F IS $35.00
SUBTOTAL
$ a4 o0
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE = $ I/9.00
Spokane County Department of BuildinqCand Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675