1992, 03-26 Permit App: 92001907 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM CA ' �`1 w
Information Worksheet ,tw
JOB STREET ADDRESS:
12604 E . 15th 1 t g
CITY/STATE/ZIP: Spokane , WA 99216 PARCEL NUMBER:_ 'ik '.',
OWNER: Al Hugill PHONE NUMBER: 924-1577
it
MAILING ADDRESS: `
(Street) (City/State) (Zip) 4,,..
Allied Heating , Inc . ALLIEI*200D4
CONTRACTOR: LICENSE NUMBER '
PHONE NUMBER: 928-8252 ,
MAILING ADDRESS: 9309 E . Trent Spokane , WA 99206 ,
(Street) (City/State) (Zip) ' ''`
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH f4''
DESCRIPTION OF UNITS UNIT = AMOUNT A '
DUCTWORK SYSTEM _ x$10.00 = '
WOODSTOVE/INSERT x 25.00 = ``
GAS WATERHEATER x 10.00 = -i
HEATING EQUIPMENT <100,000 B _[,/� T� _ 1 x 12.00 = 1 a�CSO
HEATING EQUIPMENT +100,000 B' U _ x 15. 00 = z
GAS PIPING (EA OUTLET) I x 1.00 = 1 , 00
REFRIG 1-1OOM BTU (NOT A/C OR HEAT PUMP) x 12.00 = 40*
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 = *' .10
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 = A , = .16:1'
CLOTHES DRYER x 10.00 = z.'
RANGE x 10.00 =
GAS LOG x 10.00 = :.
MISCELLANEOUS (NOT COVERED ELSEWHERE)_ _ x 10.00 = *a
UNLISTED GAS APPLIANCE <400,000 BTU_ _ _ x 50.00 = r ,{
UNLISTED GAS APPLIANCE >400, 000 BTU_ _ _ x100. 00 =
USED APPLIANCE <400,000 BTU x 50.00 = R
USED APPLIANCE >400, 000 BTU x100. 00 =
AIR HANDLER <10,000 CFM x 12. 00 = k
AIR HANDLER >10,000 CFM x 15.00 = 3'
SUBTOTAL $ 13 . 011 it
PLUS: PROCESSING FEE + $ 25.0 'P,, t
0`
EQUALS: TOTAL PERMIT , '
NOTE: MINIMUM PERMIT FEE IS $35.00 FEE DUE _ $ 38 , 00 , ; 4
SIGNATURE . 7,6____,., _L 2<4--,.. e., ^-
/
/c-, � w `"
Spokane County Department of Buildin�gq. and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675 r.
A -.
,,;ar ,U w.. ss Xa.:.a,.r.[a"" Yk:.jai.«s,i>w,a4.+3reawna•iv+w:rK:eew m,e+;ut•bs;+;,.....n.. !.i+iGN+r.aa8,,::' .,.., e..zEl'"(611' ,ad;;',rk4Y...^: ..x+3e4sKa.'tY3id