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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 /to /6 �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