1992, 09-17 Permit App: 92007763 Mechanical FixturesLA ` „:> f1&- MECHANICAL PERMIT APPLICATION FORM \ a- -1,03
"< L 1 ` 6 „Infor.-nation Worksheet
JOB STREET ADDRESS: S. 4003 Forest Meadow
CITY/STATE/ZIP: Spokane, WA 99206 PARCEL NUMBER:
OWNER: Meribelle James PHONE NUMBER: 924-7596
MAILING ADDRESS:
(Zip)
(Street) (City/State) SUNLOI107J6
CONTRACTOR: Inland Heating & Cooling
MAILING ADDRESS:
LICENSE NUMBER: SUNLOI1O1JB
PHONE NUMBER: 455-4147
3655 Govt. Way 1112 Coeur d'Alene, ID 83814
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
OF UNITS
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS; EQUIPMENT <100,000 BTU(INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
801LER/REFRIG I01 - 500M BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG'1,0001-1,750M BTU .
BOILER/REFRIG +1,750M BTU
HEAT' PUMP&:AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT.PUMP& AICONDITIONER y -x
5,30 TONS
HEAT PUMP & AIR -CONDITIONER 30-50 TONS
HEAT PUMP• CONDITIONER +50 TONS
-VENTILATING FANS
EVAPORATIVE OLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE 1(11000 •. w
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400.M BTU
ULNSTED GAS APPUNECE >400.000 STU
USED APPLIANCE <400.000 BTU
USED APPLUNiCE rn4011.000 STU
AIR HANDLER <10.000 CF7a
AIR HANDLER >10,000 CFM
(Zip)
X EACH
UNIT
= AMOUNT
1
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 =
x 50.00 =
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 -
x12.00 =
x15.00 =
10.00
15.00
2.00
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
$
PLUS: PROCESSING FEE
27.00
4-$ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=S
52.00
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA. 99260 (509) 456-3675