1993, 01-29 Permit App: 93000488 Mechanical FixturesMECH.IN!CA! PEPMIT APPLICATION FORM
�/ /Informatio/n Worksheet
JOB STREET ADDRESS: O r4 4 J �5 ( /l/ J
CITY/STATE/ZIP: (-,pUk&P Wi- ff.:7d e. PARCEL NUMBER:
OWNER: l -/JP -C DLv//aY PHONE NUMBER: .2-V-6920
MAILING ADDRESS:
(Street)
CONTRACTOR: Inland Heating & Cooling
MAILING ADDRESS:
DESCRIPTION
(City/State) SUNLOI107J6 (Zip)
LICENSE NUMBER: SUNLOI101JB
PHONE NUMBER: 455-4147
3655 Govt. Way #12 Coeur d'Alene, ID 83814
(Street)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SED.RATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS EQUIPMENT.<100,000 BTU (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS: PIPING IEA OUTLET)
BOILER/REFRIG 1-100M BTU
BOILER!REFRIG N 01-500M BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,0001-1750M BTU
BOILER/REFRIG +1,750M BTU
HEAT PUMPS AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
H qT PUMP3&`AIR. ONDITIONER 1530 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP. i: -`,I jIj CONDITIONER+50 TONS
.VENTILATING FANS
EVAPORATIVE OOLERS
TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPtirOWwr
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400.000 BTU
UUNSTED GAS APPLJAI' >400.000 BTU
USED APPLIANCE <4OOA00 BTU
USED APPLIANCE >400.000 BTU
AfR HANDLER <10.000 CF714
AIR HANDLER >10.000 CFU
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
NUMBER X EACH
OF UNITS UNIT
x 10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
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 =
x50.00 =
x100.00 =
x 50.00 -
x100.00 -
x 12.00 =
x15.00 =
= AMOUNT
lD N
SUBTOTAL
S Zoo
PLUS: PROCESSING FEE
$ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= S `h
Spokane County Division of Ptyiidings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675