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1992, 09-04 Permit App: 92007184 Mechanical Fixtures(et) 11 • Okkp S� ( MECHANICAL PERMIT APPLICATION FORM 5k15 �6,,,ktJ L $ I Infer.-nabon Worksheet JOB STREET ADDRESS: 4513 N. Larch CITY/STATE/ZIP: Spokane, WA 99216 OWNER: Don May qa-118'q PARCEL NUMBER: PHONE NUMBER: 926-6587 MAILING ADDRESS: (Street) (City/State) SUNLOI¢107J6 (Zip) CONTRACTOR:Inland Heating LICENSE NUMBER:SUNLOI101JB PHONE NUMBER: 455-4147 MAILING ADDRESS: 3655 Govt. Way Coeur d'Alene. TD 81814 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER DESCRIPTION OF UNITS ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOVE/INSERT GAS WATER HEATER 1 GAS EQUIPMENT'<100,000 BTU (INCLUDES GAS EQUIPMENT+100,000 BTU DUCTWORK) 1 GAS' PIPING'::.�'OUTLET) EA'2 :....._�,.. BOILER/REFRIG 1-100M BTU BOILEWREFFt.IGt}t'yr00M,BTU. BOILER/REFRIG 501-1,000M 811.1 BOILER/REFRIG t,000;1-1;750MBTU:: ; BOILER/REFRIG +1,750M BTU HEAT P Ifit1P<$„ TI CONDIPONER 0-3 TONS -. HEAT PUMP & AIR CONDITIONER 3-15 TONS 11EAt MPWA11 CONDITIONER 15 0JONS HEAT PUMP & AIR CONDITIONER 30-50 TONS °HEAT PL P rCONO)17ONER+50TONS`.. VENTILATING FANS EVAPORATIVE,; 30LERIS ,.:.. TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE lf}ll()N 011)�;:,.<- ,• CLOTHES DRYER GAS LOG MISCELLANEOUS (NOT COVERED ELSEWHERE UNLISTED GAS APPLIANCE <400A00 BTU UL NSTED GAS APPUANCE >400AO0 BTU USED APPUANCE <COOA00 BTU USED APPUANCE >C00 BTU AIR HANDLER <10.000 CF7A AIR HANDLER >10,000 CFR X EACH UNIT = AMOUNT 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 = x25.00 = 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 = 10.00 15.00 2.00 NOTE: MINIMUM PERMIT FEE IS $35.00 SUBTOTAL $ 27.00 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE 52.00 =S SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675