1992, 01-07 Permit App: 92000084 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: Sb -(4L qD' 19.//A.c,2)
1)ii 99,206 PARCEL NUMBER: (/54-
CITY/STATE/ZIP:
OWNER: /V 61.2rn
PHONE NUMBER:
MAILING ADDRESS: v
(Street) (City/State) (Zip)
A&M QUALM'HEATINQ LICENSE NUMBER: Apepillas3wi
121firnomirsAvE.
CONTRACTOR:
SPOKANE, WA 99 218
MAILING ADDRESS:_
s!►
PHONE NUMBER: op -240.,
(Street)
(City/State) (Zip)
AMMUMMOMMOINSIMMOIMMMmm
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
NUMBER X EACH
OF UNITS UWIT - AMOUNT
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 1,001-1,750X 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.=
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 -
NOTE: MINIM M PERMI FEE IS $35.00
SIGNATURE _
SUBTOTAL
5 36, no
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE _ $ 6/ 0
Spokane County Department of Building 'and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675