1992, 09-04 Permit App: 92007204 Mechanical Fixtures45tt1.DA°5 5
51
JOB STREET ADDRESS:
MECHANICAL PnEPMIT APPLICATION FORM
Irtor.-nation Worksheet
N. 4615 Larch
q2 --720y
130(0 z
CITY/STATEIZIP: Spokane WA 99216 PARCEL NUMBER:
OWNER: Jim Robertson PHONE NUMBER: 921-0152
MAILING ADDRESS:
CONTRACTOR:
(Street) (City/State) 3UNLOI107J6 (ZIp)
Inland Heating & Cooling LICENSE NUMBER: sI1w1.QI101JB
PHONE NUMBER: 455-4147
MAILING ADDRESS: 3655 C, nut Clay G.c.curd'Al-cxc, ID 83814
(Street) (City/State) (ZIp)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
DESCRIPTION OF UNITS
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT ..... .
GAS WATER HEATER 1
GAS'EQOI?MENT `i00;000,BTU.(INCL'UDES _ 1
GAS EQUIPMENT+100,000 BTU DUCTWORK) 2
GAS'PIPING
BOILERIREFRIG 1-100M BTU
BCr�/F� 'EPR 0°I 600M�8TC7
BOILER/REFRIG 501-1,000M BTU
0.01-f %REF;FI1G"<'F 0001= r'750M irti
BOILER/REFRIG +1,750M BTU
3iE/i7 tlatt( 1D) OOER . 3NS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
SI.F, , 'r GONDT 1ONER:�15" OTtONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
0E4 1 ' CONUt7JONEfi,350; t
VENTILATING FANS
EVAPO,,;i4TN13ALERS.:.. . .
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYgaF. .. n
P 1.1
CLOTHES DRYER
GAS LOG
MISCELLANEOUS MDT COVERED ELSEwNERE
UNLISTED GAS APPLIANCE <400A00 BTU
UNNSTED GAS APPLIANCE a STTU
USED APPUANCE «00000 BTU
USED APPLIANCE >400A00 ITU
ktR HANDI..ER.10.000 CFM
AIR HANDLER >10.000 Cat
X EACH
UNIT
a 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 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x50.00 =
x 10.00 =
x 10.00 -
x 10.00 =
x 10.00 =
x10.00 -
x 50.00 =
x100.00 -
x 50.00 -
x100.00 -
x 12.00 -
x 15.00 =
10.00
12.00
2.00
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
S
74 nn
PLUS: PROCESSING FEE
+ S 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=S 49.00
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA. 99260 (509) 456-3675