1992, 09-04 Permit App: 92007236 Water Heater, PipingMECHAWCAL PLc_.Qh J° AP=PLICATION FORKi
Information Worksheet
JOB STREET ADDRESS: 3230 N. Elton
CITY/STATE/ZIP: Spokara, WA 99212 _ PARCEL NUMBER:
OWNER: Daniel Hughes PHONE NUMBER: 927-3958
MAILING ADDRESS:
(Street) (City/State) SUNLOI107J6 (zip)
CONTRACTOR: Inland Heating & Cooling LICENSE NUMBER: SUNLOI10IJB
PHONE NUMBER: 455-4147
MAILING ADDRESS: 3655 Govt. Way #12 Coeur d'Alene, ID 83814
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT -AMOUNT
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS EQUIPMENT *100,000 BTU: (INCLUDES::
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING SEA OUTLET)
BOILER/REFRIG 1-100M BTU
BOILEFUREFiIG�D100M BTU
....... . ......5..- ........ ......: ........ .. . . -..:
BOILER/REFRIG 501-1,000M BTU
BOILER/REFAIG 1,0001. 1,750M BTU ...
BOILER/REFRIG +1,750M BTU
HEAT PUMP'y$°AIE CONDITIONER 0 3 TONS
... ... v:. ...
HEAT PUMP & AIR CONDITIONER 3-15 TONS
NEAT PUMP113 CONDI�ONE#3'730 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PIMP: &::OONDITIONER +5b TONS
,VENTILATING FANS
EVAPORATIVE COOLERS . , ; .. , .
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE'1I X1000` `<> w -
CLOTHES DRYER
RANGE ...........
GAS LOG
MISCIEUMEOUS (NOT COVERED OLSEWN04E
UNLISTED GAS APPLIANCE <400A00 BTU
ULINSTED GAS APPLIANCE >400A00 BTU
USED APPLIANCE <AWAW BTU
USED APPLJ<ANCE x,000 BTU
AIR HANDLER <I0.000 CFU
AIR HANDLER >10.000 CFU
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. _
x 50.00 =
x 10.00 a
x 10.00 =
x 10.00 =
x 10.00 -
x 10.00 -
x 50.00 -
x100.00 -
x 50.00 -
x100.00 -
1 x 12.00 =
x 15.00 =
1
10.00
1
1.00
,
a'
'
I
SUBTOTAL
$ 11.00
PLUS: PROCESSING FEE
+$ 25.00
NOTE: MINIMUM PERMIT FEE IS $35.00 EQUALS: TOTAL PERMIT
FEE DUE = S 36.00
SIGNATURE
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA. 99260 (509) 456-3675