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1992, 09-04 Permit App: 92007185 Mechanical Fixtures(A\\ t`kC`\ MECHANICAL PERMIT APPLICATION FORM rtlntor nation Worksheet Larch '� 99216 PARCEL NUMBER: JOB STREET ADDRESS: 4507 N. CITY/STATE/ZIP:Spokane, WA OWNER: Roger Rife MAILING ADDRESS: o,a-i135 1 Jo(0Z, PHONE NUMBER: 928 0584 (Street) CONTRACTOR: Inland Heating MAILING ADDRESS: 3655 Govt. Way (Street) MECHANICAL 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`„OUTLETj::: ,':''.; BOILER/REFRIG I-100M'BTU (City/State) SUNLOI107J6 LICENSE NUMBER: SUNLOI1O1JB PHONE NUMBER: 455-4147 Coeur d'Alene, ID 83814 (City/State) (Zip) WORKSHEET/FEE SCHEDULE NUMBER OF UNITS (Zip) X EACH UNIT = AMOUNT E101(*111003170114001:010.. 11; 00M18TU>' BOILER/REFRIG 501-1,000M BTU :ROILEHIREFJ IGi,000Tf41i,750M:BTU::: BOILER/REFRIG +1,750M BTU HEATPIi�p11�=CONDI�fONEH. 0-3TONS::: `_ HEAT PUMP & AIR CONDITIONER 3-15 TONS HF -#1,4* F'& 1„ :_CoNOt1 0NEf2 y5 30yoNS HEAT PUMP & AIR CONDITIONER 30-50 TONS HEA f IiN PWW CONDITIONER;+50:TONS'. .VENTILATING FANS EVAPORATIV OO,LERS::::: TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE"ul()ODT" CLOTHES DRYER • GAS LOG MISCELLANEOUS (NOT COVERED B.SEWf1aERE UNUSTED GAS APPLIANCE cs00.000 BTU ULR4STEW GAS APPUW >403=1 STU USED APPUANCE <400.000 BTU USED APPLNNCE>400,000 BTL AIR HANDLER (10.000 CFM AIR HANDLER >10S:00 CFM L 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 = x 12.00 = x 15.00 = 2 00 NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE SUBTOTAL $ 24.00 PLUS: PROCESSING FEE $ 25.00 EQUALS: TOTAL PERMIT FEE DUE 49.00 =.S Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675