1992, 09-23 Permit App: 92007967 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Informer Worksheet
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J08 STREET ADDRESS: .- 49-Ld
CITY/STATE/ZIP:
OWNER:
x/r-
PHONE NUMBER:
MAILING ADDRESS:
(Street)
CONTRACTOR: A&M QUALITY HEATING LICENSE NUMBER:
ClgarrifiNDIAIKAVE. PHONE NUMBER:
SPOKANE; WA 99216
MAILING ADDRESS:
(City/Stag) (Zip)
(Street)
Amgp c : 19 4:1
928-2100
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
OF
FUUNIITTS xUNIT
DESCRIPTION
DUCTWORK SYSTEM
WOOOSTOVE/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 ')
REFRIG 101-500M BTU
ONO
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
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
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
- AMOUNT
•x$10.00 -
X 25.00 -
x 10..00 -
X 12.00. -
x 15.00 -
X 1.00 -
X 12.00,m
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:
SIGNATURE
MUM 'ERMI. E IS $35.00
SUBTOTAL
$
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
FEE DUE
+ $ 25.00
-5306
Spokane County Department of Buildin'
land Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675