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1992, 02-26 Permit App: 92001085 Mechanical Fixtures • o� � - of 5 MECHANICAL PERMIT APPLICATION FORM Information Worksheet CA �.� JOB STREET ADDRESS: , l/ O S I ? - / Cf ‘f-k CITY/STATE/ZIP: ' / q9 0-q?ARCEL NUMBER: OWNER: - C .i<L A4 I , , PHONE NUMBER: MAILING ADDRESS. (S reet) - (City/Stats) (Zip) CONTRACTOR: A&M QUALITY HEATING LICENSE NUMBER: OIAHRIQ DJt �CuANA AVE. PHONE NUMBER: 428-2100 SPOKANE, WA 99216 MAILING ADDRESS: (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION OF UNITS XtUNIT • AMOUNT DUCTWORK SYSTEM •x$10.00 • WOODSTOVE/INSERT x 25.00 • GAS WATER HEATER x 10.00 • HEATING EQUIPMENT <100,000 BTU _ 1 x 12.00 - 11L -©r� HEATING EQUIPMENT +100,00 B _ x 15.00 • GAS PIPING (EA OUTLET) _ _ - _ x 1.00 - REFRIG 1-100M BTU (NOT A/C R HEAT ) X 12.00, • 01 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 • 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 $ j•a •0 0 0S1 PLUS: PROCESSING FEE + $ 25.00 / EQUALS: TOTAL PERMIT NOTE: _Adel ii ' "; IT yE IS $35.00 FEE DUE = $ 37'b a SSIGNATURE /J�i/i -_ - okane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675