1992, 11-02 Permit App: 92009629 Water Heater, Piping c - c\WTI
MECHAi1ICAt PERMIT APPLICATION FORM v
� / Information Worksheet 1p �
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JOB STREET ADDRESS: bit .5"0
CITY/STATE/ZIP: ;041
9 9i 0 6 PARCEL NUMBER:
OWNER: IJ PHONE NUMBER:
9a2-/-/ 963
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: Aa&M QUALITY HEATING LICENSE NUMBER: map tint 1Qui
E. 1 ftfilIUt ANA AVE. PHONE NUMBER: 928-210D
•
SPOKANE, WA 99216
MAILING ADDRESS:
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION OFUNITS xUNITHH = AMOUNT
DUCTWORK SYSTEM •x$10.00 =
WOODSTOVE/INSERT x 25.00 =
GAS WATER HEATER • / x 10.00 = /0, 00
HEATING EQUIPMENT <100,000 BTU _ _ X 12.00. =
HEATING EQUIPMENT +100,000 BTU x 15.00 =
GAS PIPING (EA OUTLET) J x 1.00. = 1. O O
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12.00, = •
REFRIG 101-500M BTU x 20:00 =
REFRIG 501-1,000M BTU x 25.00 .=
REFRIG 1,001-1,750M BTU x 35.00 =
REFRIG +1,750M BTU X 60.00 =
HEAT PUMP & AIR CONDITIONER 0-3 TONS x 12.00 =
HEAT PUMP & AIR CONDITIONER 3-15 TONS X 20.00 =
HEAT PUMP & AIR CONDITIONER 15-30 TONS _ x 25.00 =
HEAT PUMP & AIR CONDITIONER 30-50 TONS x 35.00 =
HEAT PUMP & AIR CONDITIONER +50 TONS _ x 60.00 =
VENTILATING FANS x 10.00 =
EVAPORATIVE COOLERS x 10.00 =
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) X 50.00 =
TYPE II HOOD x 10.00 =
CLOTHES DRYER x 10.00 = I
RANGE x 10.00 =
GAS LOG x 10.00 =
MISCELLANEOUS (NOT COVERED ELSEWHERE)_ _ x 10.00 =
UNLISTED GAS APPLIANCE <400,000 BTU _ x 50.00 =
UNLISTED GAS APPLIANCE >400,000 BTU_ _ _ x100.00 =
USED APPLIANCE <400,000 BTU x 50.00 =
USED APPLIANCE >400,000 BTU x100.00 =
AIR HANDLER <10,000 CFM x 12.00 =
AIR HANDLER >10,000 CFM x 15.00 =
SUBTOTAL $ //, 00
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT /
NOTE: M4 IM PE's IT FEE IS $35.00 FEE DUE = $ 3(0.00
SIGNATURE _ _` !► !__
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Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675