1993, 01-28 Permit App: 93000456 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: r� 4 J 42 ,2• '-QJ
CITY/STATE/ZIP: wA /9_)/6 PARCEL NUMBER: /
OWNER: 10a44-el PHONE NUMBER: i� - 6 e4?r _
MAILING ADDRESS:
(Street) - (City/State) (Zip)
CONTRACTOR: A&M QUALITY HEATING LICENSE NUMBER: 4)1n9JAHR,91N1
E. 127 1 MINANA AtIE. PHONE NUMBER: 428.2100
SPOKANE, WA 99216
MAILING ADDRESS:
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION OFUUNITS xUNITHH . AMOUNT
DUCTWORK SYSTEM •x$10.00 =
WOODSTOVE/INSERT x 25.00 =
GAS WATER HEATER • • x 10.00 • , 0
HEATING EQUIPMENT <100,000 BTU _ _ x 12.00./ , /, [9()te
HEATING EQUIPMENT +100,000 BTU x 15.00 •
GAS PIPING (EA OUTLET) x 1.00 a j , 00
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) X 12.00,•= •
REFRIG 101-500M BTU x 20.00 a
REFRIG 501-1, 000M BTU x 25.00 ••
REFRIG 1,001-1,750M BTU x 35.00 •
REFRIG +1,750M BTU x 60.00 -
HEAT PUMP & AIR CONDITIONER 0-3 TONS _ x 12.00 •
HEAT PUMP & AIR CONDITIONER 3-15 TONS x 20.00 =
HEAT PUMP & AIR CONDITIONER 15-30 TONS x 25.00 •
HEAT PUMP & AIR CONDITIONER 30-50 TONS - x 35.00 •
HEAT PUMP & AIR CONDITIONER +50 TONS x 60.00 •
VENTILATING FANS x 10.00 •
EVAPORATIVE COOLERS x 10.00 =
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
TYPE II HOOD x 10.00 =
CLOTHES DRYER x 10.00 =
RANGE X 10.00 •
GAS LOG x 10.00 •
MISCELLANEOUS (NOT COVERED ELSEWHERE)_ x 10.00 •
UNLISTED GAS APPLIANCE <400,000 BTU _ _ x 50.00 •
• UNLISTED GAS APPLIANCE >400,000 BTU_ _ _ x100.00 =
USED APPLIANCE <400,000 BTU x 50.00 =
USED APPLIANCE >400,000 BTU x100.00 =
AIR HANDLER <10,000 ClitEcovED x 12.00 =
AIR HANDLER >10,000 C x 15.00 •
J,.Z 2 b 1993 SUBTOTAL $ OC
PLUS: PROCESSING FEE + $ 25.00
CODE ENFORCEMENT
EQUALS: TOTAL PERMIT
NOTE: )gNI U P RMIT FEE�IS $35.00 FEE DUE $ �9, CSC
SIGNATURE___C I �X ����� /
Spokane County Department of Building 'and Safety
West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675