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1992, 07-15 Permit App: 92005311 ACMECHANICAL PERMIT APPLICATION FORM �� Information Worksheet ,(Zj fit' Sunnyside ,' 13/? t'7 - 70V JOB, STREET ADDRESS: 14106 E. CITY/STATE/ZIP: Veradale, WA 99037 PARCEL NUMBER: QWNFR: Debbie Smith yj{Qtb PHONE NUMBER: 924-0846 NAILING ADDRESS: (Street) (City/State) (Zip) CQVFRACTOR: Allied Heating, Inc. LICENSE NUMBER: ALLIEI*200D4 NAILING ADDRESS: 9309 F Trent (Street) PHONE NUMBER: 928-8252 Spokace, WA 99206 (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UTNIT DUCTWORK SYSTEM WOQDSTOVE/INSERT QA$ WATER HEATER HEATING EQUIPMENT <100,000 BTU HEATING EQUIPMENT +100,000 BTU CTAS 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 0-3 TONS _ _ AIR CONDITIONER 3-15 TONS _ AIR CONDITIONER 15-30 TONS _ AIR CONDITIONER 30-50 TONS _ AIR CONDITIONER +50 TONS _ _ FANS HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & VENTILATING g,V,PORATIVE COOLERS ''YTE I HOOD (PER 12' OR 12' PTN. OF HOOD) ' Y'E II HOOD CL9THES DRYER AGE QA,p LOG KLpCELLANEOUS (NOT COVERED ELSEWHERE)_ _ UNLISTED GAS APPLIANCE <400,000 BTU_ JNpISTED GAS APPLIANCE >400,000 BTU VSD APPLIANCE <400,000 BTU USED APPLIANCE >400,000 BTU AIg HANDLER <10,000 CFM HANDLER >10,000 CFM 1 = 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 = 12.00 NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE SUBTOTAL $ 12.00 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ 37.00 Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675