1993, 04-22 Permit App: 93002785 Mechanical Fixtures1
MECHANICAL PEP.Mi: APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: 4312 S. Forest Meadow
'f3- a>fs
/5 3'y
CITY/STATE/ZIP: Spokane WA 99206
OWNER: Bob Jewett
MAILING ADDRESS:
PARCEL NUMBER:
PHONE NUMSER: 928-1877
(Street) (City/State) SUNLOI107J6
CONTRACTOR: Inland Heating & Cooling
MAILING ADDRESS:
LICENSE NUMBER: SUNLOI101JB
(Zip)
PHONE NUMBER: 455-4147
3655 Govt. Way 1112 Coeur d'Alene, ID 83814
DESCRIPTION
(Street)
(City/State) (ZiP)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
OF UNITS
X EACH
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 (EAOUTLET)
BOILER/REFRIG 1-100M BTU
BOILE0/REFAIG11 O1 -500M BTU;
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,0001-1,750M BTU
BOILER/REFRIG +1,750M BTU
HEATPUMPAIR_CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEATRUm.p.At l,F CONDITIONER 15-30TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEATPUMP CONDITIONER+50 TONS
•VENTILATING FANS
EVAPORATEVEQOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE1f 4000 . - "
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLLWCE <400.000 BTU
ULlitSTEB GAS APPLIANCE >400.000 BTU
USED APPLIANCE <400,o00 BTU
USED APPLIANCE >400..000 BTU
ArR HANDLER <10.000 CFU
AIR HANDLER >10.000 CFI+I
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
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 =
x60.00 =
x 12.00 =
x20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x iG.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
, ,:..: 24.00
25.00
EQUALS: TOTAL PERMIT
FEE DUE
=S
49.00
Spokane County Division of Buildings