1993, 03-10 Permit App: 93001353 Mechanical FixturesfAECHAWCAL P`u;,AI T AFPLICATiON FORM
Infor.-nation Worksheet
JOB STREET ADDRESS: E'. _11820 Empir`.e :112
CITY/STATE/ZIP: cpokane,-44-QQ206 _ PARCEL NUMBER:
OWNER: Marcel Rodriguez/K. Anderson PHONE NUMBER: -927-0735
MAILING ADDRESS:
(Street) (City/State) SUNL0I107J6 (zip)
CONTRACTOR: Inland Heating & Cooling LICENSE NUMBER: SUNL0I101JB
PHONE NUMBER: 455-41.47
MAILING ADDRESS: 3655 Govt. Way 1112 Coeur d'Alene, ID 83814
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
X EACH
DESCRIPTION
OF UNITS
UNIT
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
x 10.00 =
WOODSTOVE/INSERT
x 25.00 =
GAS WATER HEATER
x 10.00 =
GAS -EQ- IPMENT°<100.000:BTU.(INCLUDES
1
x 12.00 =
GAS EQUIPMENT +100,000 BTU DUCTWORK)
x 15.03 -
GA,. PIPING`(EAOUTLET) :
x 1.00 =
BOILER/REFRIG 1-100M BTU
x 12.00 =
B0ILEF(lREFRIG✓101 BOOM 8TU <:
x 20.00 =
BOILER/REFRIG 501-1,000M BTU
x 25.00 =
B.OILER%REFRIG 1,0.001 1750M'BTU
x 35.00 =
BOILER/REFRIG +1,750M BTU
x 60.00 =
NEAT PUMP�:IE3<CONDITIONER 0-3 TONS >
:....... .
x 12.00 =
...... . ...
HEAT PUMP & AIR CONDITIONER 3-15 TONS
x 20.00 -
H,EATFUMPS&`�A1R CONDITIONER 15�OTONS
�.� ......w ka0
x 25.00 =
......... .
HEAT PUMP & AIR CONDITIONER 30-50 TONS
x 35.00 =
HEA "MP M,C.ONDIT10NER+50_TONS • ;
x 60.00 =
'VENTILATING FANS
EVAPORATIVE COOLERS
TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD)
T)PE113IOOD
CLOTHES DRYER
RANGE .....
GAS LOG
MISCELLANEOUS (NOWT COVERED O SEWHEW
UNLISTED GAS APP DANCE <400A00 BTU
UL*dSTED GAS AP!•LLANIX >400A00 BTU
USED APPLIANCE <4W,000 HTU
USED APPLIAE >�Ii0 BTU
ktR HANDLER <10.000 CIFU
AIR HANDLER >10.000 CFL
x 10.00 =
x 10.00 =
x 50.00 =
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 - I
I x 15.00 -
SUBTOTAL
PLUS: PROCESSING FEE
NOTE: MINIMUM PERMIT FEE IS $35.00 EOUALS: TOTAL PERMIT
FEE DUE
SIGNATURE
Spokane County Division of Buildings
Ind--# 1On7 Q..,na..,.,.. A...,........ C... -.L -,r,., %AIA C 00czn /Cn(_))
=AMOUNT
52400
+S 25.00
49.00
=S