1992, 12-10 Permit App: 92010805 Mechanical FixturesLscil 090c(dj
M ECH 7N:CAL Pf.RMF :- APPLICATION FORM
Il U CLL 6-3 0. Information Worksheet
JOB STREET ADDRESS: 4706 N. Conklin
CITY/STATE/ZIP: Spokane, WA 99216
OWNER: John Robert
9z-inao5
-789
MAILING ADDRESS:
PARCEL NUMBER:
PHONE NUMBER: 922-3051
(Street) (City/State) SUNLOI10736 (ZIP)
CONTRACTOR: Inland Heating & Cooling LICENSE NUMBER: SUNLOI101JB
MAILING ADDRESS:
PHONE NUMBER: 455-4147
3655 Govt. Way 1112 Coeur d'Alene, ID 83814
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS-EQUIPMENT<100,000 BTU (INCL'IJDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
BO!LEUIR,EFAIG1J01-500M BTiI><
BOILER/REFRIG 501-1,000M BTU
BOILER/REFAIG :1,0001.-1;750M BTU
BOILER/REFRIG +1,750M BTU
HEAT=P1/MP & AIRCONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEATA0.01g 1,0 CONDITIONER 1.5- 30`TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEATPLJMP;,„C_ONDITIONER +50 TONS
.VENTILATING FANS
EVAPp9OST, OOOLERS
TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPEi010067-Ncir;- S.:
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400.000 BTU
ULINSTED GAS APPLIANCE >400.000 BTU
USED APPLIANCE <400.000 STU
USED APPLIANCE >400A00 BTU
AfR HANDLER <10.000 CfA
AIR HANDLER >10,000 CFM
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
1
2
x 10.00 =
x 25.00 =
x 10.00 =
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 =
x 10.00 =
x 10.00 =
x50.00 =
x10.00 -
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 =
10.00
12.00
2.00
SUBTOTAL
S 24.00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
49.00
=S
Spokane County Division of Buildings
\A/.,. ♦ , ono Q.., -,.-i,.,-,., n., ..,, c.,.,Lor,o \A/G aoogn (nd\ Aga_' 7ci