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1992, 09-04 Permit App: 92007200 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM Ct ` 1200 Infor..natiowworlkaheet 3cco Z JOB STREET ADDRESS: 4610 N. Larch A. CITY/STATE/ZIP: Spokane, WA 99216. PARCEL NUMBER: OWNER: Don Daniels PHONE NUMBER: 927-0480 MAILING ADDRESS: (Street) (City/State) SUNLOI 10 7 J 6 (Zip) CONTRACTOR: Inland Heating & Cooling LICENSE NUMBER: SUNLOI101JB PHONE NUMBER: 455-4147 MAILING ADDRESS: (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER DESCRIPTION OF UNITS ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) x 10.00 = WOODSTOVE/INSERT x 25.00 = GAS WATER HEATER 1 x 10.00 = GASiEQUIPMENT:<100,000 BTU(INCLUDES _ 1 x 12.00 = GAS EQUIPMENT +100,000 BTU DUCTWORK) x 15.03 = GAS1PIPINGiEAC+UTLET):; ": 2 x 1.00 = BOILER/REFRIG 1-100M BTU x 12.00 = 801TISF,13c- r af01 500M:Otti :,': <` < .'i ` . c .. x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = BOLLEWREFA1G=1-,cooP7.;750M BTU '; . _..::.'. x 35.00 = BOILER/REFRIG +1,750M BTU x 60.00 = 7t 11,jVIP AIEI CONI300NER:0 M3 TONS':.•. •x 12.00 = HEAT PUMP & AIR CONDmONER 3-15 TONS x 20.00 = .n:... v..: <wYY..n Y "inyxvi"..:.n..:..:.: ...:....xw...:..:...ww: w4.wp..v.,j" ,. EA7 , ,11IP'&?, ►1,.it00014MONEft 7 30wTONS:: ,::::':_,. x 25.00 = HEAT PUMP & AIR CONDITIONER 30-50 TONS x 35.00 = :HEATPI'I P„,� ge,NDLTLONEH;+50`TONS`.:: _<,.I',,a_��.�� .:, ,..: x 60.00 = VENTILATING FANS x 10.00 = EVAPDRATIVE_QO,LERS x 10.00 = TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = TYPE II_IOOd=: 4 : x 10.00 = CLOTHES DRYER x 10.00 = RANGE : x 10.00 = GAS LOG x 10.00 - MISCELLANEOUS (NOT COVERED ELSEWHERE x 10.00 - UNLISTED GAS APPLE <400.000 BTU x 50.00 - UIJNS'TED GAS APPUANCE >4QOMO BTU x100.00 = USED APPUANCE ce00,000 BTU x 50.00 - USED APPLIANCE CO BTU x100.00 - AIR HANDLER c10.000 Gnu x 12.00 = AIR HANDIER >10,000 CFM x 15.00 = X EACH UNIT (Zip) = AMOUNT 10.00 12.00 2.00 NOTE: MINIMUM PERMIT FEE IS $35.00 SUBTOTAL $ 74 00 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE 49.00 =5 SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675