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1992, 01-24 Permit App 92000416 Wtr Htr Htg EquipLW°. • DESCRIPTION DUCTWORK SYSTEM WOODSTOVE/INSERT GAS WATER HEATER HEATING EQUIPMENT <100,000 BTU HEATING EQUIPMENT +100,000 BTU GAS 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 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 MECHANICAL PERMIT APPLICATION FORM _ Information orksheet, JOB STREET ADDR,SS: �� - (/(�� 6 - �./Jhl-t� CITY/STATE/ZI':_ . f OWNER: MAILING DRESS: CONTRACTOR: PARCEL NUMBEt: PHONE NUMBER: (Street) (City/State) (Zip) A&M QUALITY HEATING LICENSE NUMBER: AKWAIMA41N1 E 1 Pr&TNT)IANA AVE. SPOKANE, WA 99216 MAILING ADDRESS: PHONE NUMBER: 928-2100 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH OF UNITS UNIT NOTE: SIGNATURE PERMI EE IS $35.00 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 = SUBTOTAL PLUS: PROCESSING FEE = AMOUNT �0 o [-Q-1C ..Or) + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE Lokane County Department of Building_sand Safety West 1303 Broadway Avenue Spokane, WA 9260 (509) 456-3675 = $ _ OD