1992, 02-28 Permit App: 92001148 Water Heaterw°rT��Lt� g�
JOB STREET ADDRESS:
CITY/STATE/ZIP:
OWNER:
MAILING AD
� a - (1 '1'`
MECHANICAL PERMIT APPLICATION FORM
Intormatio orksheet 97'-(
t 3
o)?9c P CEL NUMBER:
PHONE NUMBER:_ 7 - -
CONTRACTOR:
85 : , Q_-yv JQ
(Street)
(City/State) (Zip)
A&M QUALITY HEATING LICENSE NUMBER: yinp4IDII4 1,11 :
1 ffitTiVaNA AVE.
SPOKANE; WA 99216
MAILING ADDRESS:
PHONE NUMBER: t211- 21oQ
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
OF UNITS XUNITx - AMOUNT
DESCRIPTION
(Zip)
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 T PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
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
•X$10.00 -
x 25.00 -
X 10.00 -
x 12.00. -
x 15.00 •
x 1.00 -
X 12:00,, oi
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 =
! • m. d
NOTE:
SIGNATURE
RMIT1FEE IS $35.00
,/ AO
SUBTOTAL
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE = $ 3.57
Spokane County Department of Buildingtand Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675