1993, 01-28 Permit App: 93000458 Mechanical FixturesJOH
MECHANICAL PERMIT APPLICATION FORM
S � Information Worksheet
JOS STREET ADDRESS: Ea.,<L //// // S e , -! `ti
// 992o(. PARCEL NUMBER:
3`-'
CITY/STATE/ZIP:
OWNER: £ A -LI ' xL
PHONE NUMBER:
MAILING ADDRESS:
CONTRACTOR:,
(St=et)
AAM QUALITY HEATING
L
SPOKANE,; WA 99216
MAILING ADDRESS:
97..f2/96
(City/Stag) (Zip)
LICENSE NUMBER: wwej»:43u:
PHONE NUMBER: 4zi.2inn
(Street)
(City/Stats) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION OFUNIITTS xUNITH
x
DUCTWORK SYSTEM_
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT 4100,000 BTU
HEATING EQUIPMENT +100,000 BTU
GAS PIPING (EA OUTLET)
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP)
REFRIG 101-500N BTU
REFRIG 501-1,000M BTU
REFRIG 1,001-1,750M BTU
REFRIG +1, 7SOM BTU „ ,_ -_ _
HEAT PUMP & AIR CONDITIONER 03 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
f
- AMOUNT
•x$10.00 -
X,25.00 -
x 10.00 •-
X 12.00.m
X 15.00 -
X„ 1.00 -
x 12.00,
X 20.00 -
x 25.00.m
x
5.00. -
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 •
.OQ
,OD
,1, D o
NOTE: MIN MUM.P;RMIT4FEE IS $35.00
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE _ $
Spokane County Department of Buildin rand Safety
West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675