1990, 10-04 Permit App: 90005118 Mechanical FixturesANICAL PERMI?-AP .UCATION
Information Worksheet
JOB STREET ADDRESS:
S. 1109 Robin
CITY/STATE/ZIP: Spokane. WA 9,9206
OWNER: Ed & Candy Anderson
MAILING ADDRESS: S. 1109 Robin Hood
(Street)
CONTRACTOR: Allied Heating, Inc.
Hood
d--S//oma
FORM -
igG I'(
'10HON'E NUMBER:
MAILING ADDRESS: E. 9311jTrent
928-8442
Spokane, WA 99206
(City/State)
ALLIEI*200D4
LICENSE NUMBER:
(Zip)
PHONE NUMBER: 928-8252
(Street)
Spokane, WA 99206
(CitY/State) (ZiP)
WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION`
DUCTWORK SYSTEM_
WOODSTOVE/INSERT`
GAS WATER HEATER;_, _
HEATING EQUIPMENT <100,000
HEATING EQUIPMENT +100,000
GAS PIPING (EA OUTLET) -
REFRIG 1-100M BTU (NOT A/C
REFRIG 101-500M BTU _
REFRIG 501-1,000M BTU-_>
REFRIG 1,001-1,750M BTU -
REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I.. OOD (PER 12' OR 12' PTN. OF' HOOD})
TYPE II HOOD
CLOTHES DRYER_
RANGE
GAS LOGS__ __________ _
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
OR HEAT PUMP)
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
NOTE:
SIGNATURE
SUBTOTAL.
PLUS:
EQU
AMOUNT
x$10.00 =
x 25.00 =
x 10.00 =
x 12.00
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
PROCESSING FEE
LS: TOTAL PERMIT
FEE DUE
Spokane CountDepartment of Building and Safe
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
J
00