1993, 01-14 Permit App: 93000151 Mechanical Fixtures3\i\�L-[-SU-3,
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MECHANICAL PERMIT APPLICATION FORM
InformationWorksheet
JOB STREET ADDRESS: q /00 1
CITY/STATE/ZIP: el Cf%A 1.9,)0 6 PARCEL NUMBER:
OWNER: G PHONE NUMBER: 9,71g - O /7".(3
MAILING ADD SS:
i
�,'
CONTRACTOR:
(Street)
(City/Stag) (Zip)
A&M QUALITY HEATING LICENSE NUMBER:
E. 1fti"ONiD NA AVE.
• SPOKANE; WA 99216
MAILING ADDRESS:
A114flyAHR19 9114 1
PHONE NUMBER: 92B-2100
(Street)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
OF UNITS UNIITx
DESCRIPTION
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (EA OUTLET)
REFRIG 1-100M 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.
x 15.00 -
X„ 1.00..•
X 12.00,=
X10.00+■
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 -
DO
NOTE:
SIGNATURE
NIMUM PE
EE IS $35.00
SUBTOTAL
$c oc
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
$/90o
Spokane County Department of Buildin 'and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675