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�