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1992, 10-15 Permit App: 92008949 Mechanical FixturesJOB STREET ADDRESS: CITY/STATE/ZIP: OWNER: MECHANICAL PERMIT APPLICATION FORM (c Information Worksheet /// 9 /< .c4 GcM ! 9,t1 6 PARCEL NUMBER: " /. 0�� 44z4 /1it,/ PHONE NUMBER: qoq 7 30 �O S MAILING ADDRESS: (Street) CONTRACTOR: A&IM QUALITY HEATING 11 /11th ANA"'AVE. SPOKANE; WA 99216 MAILING ADDRESS: (City/State) (Zig LICENSE NUMBER: A+Quna AIVIN1 PHONE NUMBER: 9Z8 -210a (Street) (City/State) (Zii MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH OF UNITS UNIT - AMOUN' DESCRIPTION DUCTWORK SYSTEM WOOOSTOVE/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 & AIR CONDITIONER 0-3 TONS HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT PUMP & AIR CONDITIONER 15-30 TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMP & AIR CONDITIONER +50 TONS VENTILATING FANS 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 a •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 - A NOTE: MI;, MU PERMIT FEE IS $35.00 SIGNATURE Spokane County Department of Building/and Safety West 1303 Broadway Avenue Spokane. WA 99260 (509) 456-3675 SUBTOTAL 014.6 PLUS: PROCESSING FEE + $ 25.1 EQUALS: TOTAL PERMIT FEE DUE = $ 1/900