1993, 06-08 Permit App: 93004468 AC . . 93- L 4j6 8
.MECHANICAL PERMIT APPLICATION FORM a/g y
Information Worksheet
JOB STREET ADDRESS: 3'7/a 3 ( k/t) '
CITY/STATE/ZIP: `l 9 9, O & PARCEL NUMBER:
OWNER: A Z4'L) PHONE NUMBER: 9, g_v4 6 a
MAILING ADDRESS:
(Street) (City/State) (Zip)
CONTRACTOR: AIM QUALITY,- � HEATING LICENSE NUMBER: wsnyuxatalmi
E. Z j�1i T1[t h41VkA'�/E. PHONE NUMBER: 9211-2100
• SPOKANE; WA 99216
MAILING ADDRESS:
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION OFUNITS EAC
= AMOUNT
DUCTWORK SYSTEM •x$10.00 =
WOODSTOVE/INSERT x 25.00 _
GAS WATER HEATER x 10.00 =
HEATING EQUIPMENT <100,000 BTU , x 12.00• •
HEATING EQUIPMENT +100,000 BTUx 15.00 =
GAS PIPING (EA OUTLET) x 1.00
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12.00,611 •
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 = 1124 ,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 =
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 <10,00 0Ha3
p4NQ,OQ _ _ _ x 12.00 =
AIR HANDLER >10,00 � x 15.00 =
£66L 6 Nur SUBTOTAL $ /a. 0 0
A H����
PLUS: PROCESSING FEE + $ 25.00
�3,`9
EQUALS: TOTAL PERMIT r�
NOTE: M UM iel,PERMIT FEE IS $35.00 FEE DUE = $ 3 /'00
SIGNATURE_ _ e
Spokane County Department of Building anOd Safety
456-3675
West 1026 Broadway Avenue Spokane, WA 9 (