1992, 08-10 Permit App: 92006270 Mechanical FixturesJOB STREET ADDRESS:
CITY/STATE/ZIP:,
OWNER: -711�
�bAt_e_
MECHANICAL PERMIT APPLICATION FORM LI
Information Worksheet
LUQ /1 9'92//PARCEL NUMBER:
4. ///2 . e/61
PHONE NUMBER:
MAILING ADDRESS:
(Stra•t) - (City/State) (Zip)
CONTRACTOR:
A&M QUALITY HEATING LICENSE NUMBER: syQuAIIN191N1
E. 1ei id'iNCUNXA'VE.
SPOKANE; WA 99216
MAILING ADDRESS:
PHONE NUMBER: 928-2100
(Street)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
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
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
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
AMP
= 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 =
,00
NOTE: MINIMU PERMIT EE IS $35.00
/
SIGNATURE
SUBTOTAL
$ a400
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE = $ y(?, 00
Spokane County Department of Buildinq 'and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675