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1992, 09-18 Permit App: 92007785 Mechanical Fixtures
tifice 5 JOB STREET ADDRESS: N. MECHANICAL PERMIT APPLICATION FORM Information Worksheet 3017 Bowslish 93--/ (0Z9 CITY/STATE/ZIP: Spokane, WA 99206 PARCEL NUMBER: OWNER:Anna Privrat sky MAILING ADDRESS: PHONE NUMBER: 928-2294 (Street) (City/State) SUNLOI107,16 (Zip) CONTRACTOR: Inland Heating & Cooling MAILING ADDRESS: LICENSE NUMBER: SUNLOI101,113 PHONE NUMBER: 455-4147 3655 Govt. Way #12 Coeur d'Alene, ID 83814 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER OF UNITS DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOVEJINSRT GAS WATER HEATER GAS:EQ01fiAENT';000,000 BTU (INCLUDES GAS EQUIPMENT +100,000 BTU DUCTWORK) GAS PiPING (EA OUTLET) BOILER/REFRIG 1-100M BTU BOCLEWEFRIGIIi4Ocit4itit: BOILER/REFRIG 501-1,000M BTU ppj14.0kFig99101 ;000141:j:50m BTU BOILER/REFRIG +1,750M BTU tiFOlegie*J01:001PMP0 HEAT PUMP & AIR CONDITIONER 3-15 TONS , DITIONER4540IONS HEAT PUMP & AIR CONDITIONER 30-50 TONS EATOMCOND1T1ONER +50 TONS -"- ,VENTILATING FANS EYAppeg.1200PLERS TYPE 1 HOOD (PER 12' OR 12' PIN. OF HOOD) TYITOLOOL/nr«- CLOTHES DRYER RANGE GAS LOG MISCELLANEOUS (NOT COVER83 ELSEWHERE UNLISTED GAS APPUANCE <400.000 STU OLMSTE) GAS APPLIANCE >400.000 STU USED APPLIANCE e.400000 BTU USED APPUANCE1,1011X0 �TU £rR MANDLEFI <10.000 CFA* AIR HANDLER >10.000 CFM X EACH UNIT = AMOUNT 1. 1 2 x10.00 = x 25.00 = x10.00 = x 12.00 = x 15.03 = 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 = x10.00 = x10.00 = x 50.00 = x10.00 x10.00 x10.00 = x10.00 = x10.00 = x 50.00 = x100.00 = x50.00 = x100.00 = x 12.00 = x 15.00 = 10.00 12.00 2.00 NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE SUBTOTAL $ 24.00 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE 49.00 =.$ Spokane County Division of Buildings Wt 1fl Rrnadwav Avenue Spokane, WA 99260 (509) 456-3675