1993, 02-24 Permit App: 93001051 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM
Information Worksheet -ZZCO 9
JOB STREET ADDRESS: /V 61/2-L/1.. 430 6 X_-?- ) i&aa
CITY/STATE/ZIP: �1 &4 99,2/6 PARCEL NUMBER:
OWNER: a i ' /a PHONE NUMBER: ,V7- /Y' 7
MAILING ADDRE S:
(Street) - (City/Stats) (Zip)
CONTRACTOR: A&M QUALITY HEATING LICENSE NUMBER: AMQIIARR19)N1
t 1'fi 1"tiNDIANK A'VE. PHONE NUMBER: 92a-21n0
• SPOKANE; WA 99216
MAILING ADDRESS:
(Street) (City/State) (Zip)
INNNNINNNNIIIMEINININIIMIMIEIIIIIMIIIIIIIIIIIIIIIIIIIIOIIIIIIIIIIIIIIMIIOIIIIIIMIIIIIIMIMIIIUIIIIMIMIIMIIIIIMIMIIMIMEEIIIMIEIMMIIMNNI
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH . AMOUNT
DESCRIPTION OF UNITS UNIT
DUCTWORK SYSTEM •x$10.00 •
WOODSTOVE/INSERT x 25.00 •
GAS WATER HEATER ' / x 10..00 as /10, :00
HEATING EQUIPMENT <100,000 BTU _ _ _ _ _ / X 12.00go i,g , O0
HEATING EQUIPMENT +100,000 BTU x 15.00 •
GAS PIPING (EA OUTLET) a x„ 1.00. • , O D
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) X 12.00,416
REFRIG 101-500M BTU x 20.00 = •
REFRIG 501-1,000M BTU x 25.00 .
REFRIG 1,001-1,750M BTU x 35.00 •
REFRIG +1,750M BTU x 60.00 -
HEAT PUMP & AIR CONDITIONER 0-3 TONS _ _ x 12.00 -
HEAT PUMP & AIR CONDITIONER 3-15 TONS _ x 20.00 •
HEAT PUMP & AIR CONDITIONER 15-30 TONS _ x 25.00 •
HEAT PUMP & _
AIR CONDITIONER 30-50 TONS x 35.00 -
HEAT PUMP & AIR CONDITIONER +50 TONS _ _ x 60.00 •
VENTILATING FANS x 10.00 •
EVAPORATIVE COOLERS X 10.00 •
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) X 50.00 •
TYPE II HOOD X 10.00 •
CLOTHES DRYER x 10.00 •
RANGE X 10.00 -
GAS LOG x 10.00 •
MISCELLANEOUS (NOT COVERED ELSEWHERE)_ _ X 10.00 •
UNLISTED GAS APPLIANCE <400,000 BTU_ _ _ x 50.00 •
UNLISTED GAS APPLIANCE >400,000 BTU_ _ _ x100.00 -
USED APPLIANCE <400,000 BTU x 50.00 •
USED APPLIANCE >400,000 BTU x100.00 •
AIR HANDLER <10,000 CFM x 12.00 =
AIR HANDLER >10,000 CFM x 15.00 - 'I
SUBTOTAL $ oC 4. 0 O
^PLUS: PROCESSING FEE + $ 25.00
^
EQUALS: TOTAL PERMITp
NOTE: M I 'E' ; T FEE IS $35.00 FEE DUE = $ 1, 00
FA
SIGNATURE_ __ (/
Spokane County Department of Buildin�g260d Safety
456-3675
West 1303 Broadway Avenue Spokane, WA 9