HomeMy WebLinkAbout1993, 03-16 Permit App: 93001519 Mechanical Fixtures3 . Cl .. i 5 1 9
P O & 5A oZ MECHANICAL PERMIT APPLICATION FORM ����
L— 3 / 6 Information Worksheet` dA
Z,
STREET ADDRESS: 3 70' rn.e4'eU d"'
CITY/STATE/ZIP: 9 9 ( D CD PARCEL NUMBER:
PHONE NUMBER: 9a / - / p
t si
OWNER:
MAILING ADDRESS:
(Street)
CONTRACTOR: A&M QUALITY HEATING
E 1 fi itTFJ ANAAAVE.
SPOKANE, WA 99216
MAILING ADDRESS:
(City/State) (Zip)
LICENSE NUMBER: 4149NumiQ wi
PHONE NUMBER: 928-2100
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
N
OUMBERS X EACH
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
EVAPORATIVE
TYPE I HOOD (PER 12' OR 12' PTN. OF'HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
COOLERS
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
(Zip)
= 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 is
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 =
fi So
a, co
NOTE: MltMUM P RM -£ IS $35.00
SIGNATUREG(
SUBTOTAL
$ (29, 00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
$ 44 9, 0 0
Spokane County Department of Buildinq'and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675