1992, 09-04 Permit App: 92007186 Mechanicla FixturesC�1\- 051-3 L 13
Gj MECHANICAL PERMIT APPLICATION FORM
�\,r�k5 6--1-- �" a _ Information Worksheet
JOB STREET ADDRESS: 4 713 N. Lillian
CITY/STATE/ZIP: Spokane, WA 99216 PARCEL NUMBER:
OWNER: Robert Robertson
MAILING ADDRESS:
2. - 1
PHONE NUMBER: 928-51/15
CONTRACTOR[nlan
1 . .
(Street)
1 •
MAILING ADDRESS: 3655 Govt Way
DESCRIPTION
(Street)
•
(City/State) S U N L 0 I 10 7 J 6
LICENSE NUMBER: SUNLOI101JB
PHONE NUMBER: 4 5 5 - 414 7
(Zip)
'rnPur d'Alene, ID 83814
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
OF UNITS
(ZP)
X EACH
UNIT
= AMOUNT
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS EQIIPi�AEN X00,000 BTU(INCLUDES
GAS EOUIPfMENT+100,000 BTU DUCTWORK)
GAS;P.IPI G'(EA UTLE1)
BOILER/REFRIG 1-100M BTU
-00:40A-0,14014.0011..., U
BOILER/REFRIG 501-1,000M TU
BOIL EFR G•_`1,0001 1750M
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR. CONDITIONERCND3716_7 NS
Y..NE1'_ONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
H
.02111611K.,- NDITIONER 50 ONS
.VENTILATING FANS
TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD)
T11'PE ('6T47
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED EISEINHERE
UNUSTED GAS APPLIANCE <400.003 STU
ULNST® GAS APPLIANCE >400A00 STU
USED APPLIANCE <400.000 BTU
USED APPLIANCE x.000 STU
AIR HANDLER <10.000 CFM
AIR HANDLER >10.000 CFM
1
1
2
1.
x 10.00 -
x 25.00 =
x 10.00 =
x12.00 =
x 15.03 =
x 1.00 =
x 12.00 -
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
•x12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 -
x10.00 -
X 10.00 -
X 10.00 -
X 10.00 -
X 10.00 -
x 50.00 -
X100.00 -
x 50.00 -
x100.001.
I
100.00-
1 x 12.00 =
x 15.00 -
10.00
2.00
NOTE: MINIMUM PERMIT FEE 15 $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