1993, 05-26 Permit App: 93003994 Mechanical FixturesJOB STREET ADDRESS:
MECHANICAL FERMI: APPLICATION FORM
Information Worksheet
11415 Fairview
1:P P5106-1
CITY/STATE/ZIP: Spokane, NA 99206
OWNER: James Stucbell
MAILING ADDRESS:
PARCEL NUMBER:______
PHONE NUMBER: 921-0911
(Street) (City/State) SUNLOI107J6 (Zip)
CONTRACTOR: Inland Heatini, & Cooling, LICENSE NUMBER: SUNLOI1O1JB
PHONE NUMBER: 455-4147
MAILING ADDRESS: 3655 Govt. Way 1112 Coeur d'Alene, Ill 83814
(Street)
(City/State) (ZiP)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVEIINSERT
GAS WATER HEATER
GAS EQUIPMENT <100,000 BTU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)'::
BOILER/REFRIG 1-100M BTU
801LERIREFRIG�y 01-500M: BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1;0001-1,750M BTU
BOILER/REFRIG +1,750M BTU
HEAT"PUMP SIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT,P:I MPS&`f JR CONDITIONER 15-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT161)MP: E CONDITIONER*50 TONS'•
.VENTILATING FANS
EVAPORATIV0D,OLERS
TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE1I:.IOOD . <.7.-
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNUSTED GAS APPLIANCE «00.000 STU
ULINSTED GAS APPLM? E >400.000 BTU
USED APPLIANCE <400000 BTU
USED APPLIANCE >400.000 BTU
ArR KANOL EA <10.000 CFM
A1R HANDLER >10.000 CFU
NOTE: MINIMUM PERMIT FEE IS 535.00
SIGNATURE
NUMBER
OF UNITS
X EACH
UNIT = AMOUNT
1
1
2
x10.00 =
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 =
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
10.00
12.00
2 00
SUBTOTAL
PLUS: PROCESSING FEE
S
2/t.00
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=S
49.00
Spokane County Division of Buildings