1992, 11-18 Permit App: 92010167 Mechanical Fixturesw-kuj- ? = MECHANICAL PERMIT APPLICATION FORM
I 0 ;" `T Informat ion Worksheet
F/ 9 ?e—()e))-2-J
JOB STREET ADDRESS:
)'(L/
CITY/STATE/ZIP: < l wA 9'L2 PARCEL NUMBER:
OWNER:j)/2/WiiiL4.)241-1Y-44/ PHONE NUMBER: 9,:.? 0 -3 3' V02,
MAILING ADDRESS:
CONTRACTOR:
MAILING ADDRESS:
(Street)
A&M QUALITY HEATING
E 12 11 ANA'AVE.
SPOKANE; WA 99216
(City/State) (Zip)
LICENSE NUMBER: Apaumaals:
PHONE NUMBER: 928-2100
(Street)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
OFUNIITTS XUNIT
DESCRIPTION
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (EA OUTLET)
REFRIG I -100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500M BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1,750M BTU
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
0-3 TONS _
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
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. se
x 15.00 =
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 =
a , fo O
NOTE: MIMUM PERM/T FEE IS $35.00
SIGNATURE-- ,1 ,r/ x//48.14 1""P
/
Spokane County Department of Buildinlland Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
SUBTOTAL
$ ayoo
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE = $ 1{9%00