1993, 06-07 Permit App: 93004367 Mechanical FixturesMECHAN!CAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: 11 316 FredPri ek
C3q)77
/5-7y
CITY/STATE/ZIP: Spokane, WA 99206
OWNER: o] -m Cuddy .Tr
MAILING ADDRESS.
PARCEL NUMBER:
PHONE NUMBER: 9 2 2-0 03 3
(Street) (City/State) SIINL0.1107,16 (Zip)
CONTRACTOR: Inland flea Lany, & Coolint;
MAILING ADDRESS:
LICENSE NUMBER SUNL:I101JB
PHONE NUMBER: 455-4147
3655 Govt.. Way //12 Coeur d'Alene, Ill 83814
(Street)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
OF UNITS
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
W00DSTOVE/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
BOILER/REFRIG 101-,500M.BTU.,
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG_1,0001-1;750M BTU:'
BOILER/REFRIG +1,750M BTU
HEAT.PUMR &':AIR.CONDITIONER t)=3'TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEATRlimt4.? kjimONDITIONER:75=30'TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT POMP& ANCONDITIONER 450 TONS
VENTILATING FANS
EVAPQRATINE;COOLERS
TYPE 1 HOOD (PER 12' OR 12 PTN. OF HOOD)
TYPE 101 -DOD ItZ
CLOTHES DRYER
RANGE
GAS LOG
IAISCEIL NEOUS (NOT COVERED E1.SEW1€J E
UNLtS t to GAS APPtWcE <a00,000 BTU
U'JNS'TED GAS APPI >400A00 BTU
USED APPLIANCE <a00,000 BTU
USED APPLIANCE>a00A00 STU
ArR HANDLER <t 0.000 CFL
AIR HANDLER >10.000 CFU
NOTE: MINIMUM PERMIT FEE IS 135.00
SIGNATURE
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 =
x20.00 =
x 25.00 =
x35.00 =
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
x 12.00
x 15.00
10.00
12 00
7 n0
SUBTOTAL
PLUS: PROCESSING FEE
24 00
5 25.00
EOUALS: TOTAL PERMIT
FEE DUE
=s 49.00
Spokane County Division of Buildings
•