1990, 01-16 Permit App: 90000181 Furnace, PipingJOB STRIDET ADDRESS:
CITY/STATE/E
OWNER:
MECHANICAL PERMIT APPLICATION FORM
Information W•rksheet
g,4 A w.
ARCEL NUMBER:
PHONE NUMBER:
MAILS MURESS /
(City/State) (Zip)
A & M QUALITY HEATING, INC. LICENSE NUMBER: AM ()U A 4E-- (43 Ail
127f0a
Spokane, Washington 99216 PHONE NUMBER: ?a.r a f D
Q
(Streert)
Re;?_.
MAILING. ADDRESS:
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
(Zip)
=AMOUNT
DUCTWORK, SYSTEM
WOODSTOVINSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIVING (5 OR MORE. EACH:)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,0.01-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS _
HEAT -' r & AIR CONDITIONER 15-30 TONS _
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR CONDITIONER +50 TONS
VENTILATING FANS - -
EVAPORATIVE COOLERS
TYPE I HOO=D ' (PER 127 ER i/4 ' 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 A,),P jj'�_
•C
c
f
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x. 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
f OQ
/'•oO
NOTE: TRUK PERMIT F'E IS $35.00
SIGNATURE
SUBTOTAL
$ /3.oa
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509
456-3675