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1990, 01-16 Permit App: 90000186 FurnaceJOB STREET ADDRESS: MECHANICAL PERMIT APPLICATION FORM DIformattlon Worksheet CITY/STATE/ZIP '�, GU ! ��/1 4p PARCEL NUMBER: OWNER: l� ` PHONE NUMBER • / ` r 7 �/ gri MAILING ADDRESS: (Street) -(City/State) (Zip) CONTRACTOR: A & M !fi(KAT[% I!!C. LICENSE NUMBER: 4(11 )0-0-4 f T.3 E. 12710 Indiana PHONE NUMBER: v._ -- ,R(a Spokane, Washington 99216 MAILING ADDRESS: (City/State) (Zip) (Street) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH OF UNITS UNIT DESCRIPTION = AMOUNT DUCTWORK SYSTEM WOODSTOVE/INSERT 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 501-1,000MUBTU REFRIG 1,001-1,750M BTU REFRIG +1,750M BTU AIR CONDITIONER 0-3 TONS AIR CONDITIONER 3-15 TONSr _ AIR CONDITIONER 15-30 TONS AIR CONDITIONER 30-50 TONS AIR CONDITIONER +50 TONS FANS HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & VENTILATING 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 f x$10.00 x 25.00 x 10.00 x 12.00 x 15.00 x 1.00 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: MIUM P RMIT EE IS $35.00 SIGNATURE Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 SUBTOTAL PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ 37,e�