1989, 10-11 Permit App: 89003987 Mechanical FixturesJOB STREET ADDRESS:
CITY/STATE/ZIP:
OWNER:
MECHANICAL PERM1T APPLICATION FORM
Information Worksheet
egitt0A�..-
W A -q 9 Db PARCEL NUMBER:
PRONE NUMBER: 9 c - b v� L
MAILING ADDRESS:
[a2irvlx
(Street)
CONTRACTOR: A & MGW1 JTY HEATING. INC.
E. 12710 Indiana
Spokane, Washington 99216
MAILING ADDRESS:
(Zip)
(City/State) (Zip)
LICENSE NUMBER: A /y Qu/4/E / t3 WY -
PHONE NUMBER: ?Jag- RWO
(Street)
(City/State)
MECHANICAL JWORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT
= ` AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIEING (5 OR MORE. EACH:)
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 & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE IZ 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
T
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00=
x 15.00 =
x 4.00 =
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 =
to,
do
/a
NOTE:
SIGNATURE
NUN PE
P E I 35.00
SUBTOTAL
PLUS: PROCESSING FEE
$ av o o
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $
Spokane C(unty Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675