1992, 09-04 Permit App: 92007201 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
. Intor..natio ; Worksheet
.17
JOB STREET ADDRESS: 4616 N. 1 a r r h
CITY/STATE/ZIP: Spokane, wA 99216 PARCEL NUMBER:
OWNER: Craig Graff PHONE NUMBER: 977-3091
MAILING ADDRESS:
c -120 \
(Street) (City/State) 3UNLOI107J6 (Zip)
CONTRACTOR: Inland Heating & Cooling LICENSE NUMBER: SITNT,OT1 01 Jg
PHONE NUMBER: 455-41/7
MAILING ADDRESS: 3655 Govt. Way Coeur d'Alpnp, TD 83-81h
(Street) (City/State) (ZiP)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
DESCRIPTION OF UNITS
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOOOSTOVE/INSERT
GAS WATER HEATER 1
GAS EQf1IPM.EN $700,000 STU:(INCLUDES. 1
GAS EQUIPMENT +100,000 BTU DUCTWORK)
AS;P1PWGIF? UTLE-0
BOILERIREFRIG 1-100M BTU
BOILERIREFRIG 501-1,000M BTU
007 EFAIG 'I;1o01=Lii50M BTU' j m'..
BOILERIREFRIG +1,750M BTU
HEA?�1'li PerGONDI $ONS 3>70NS ` ...::.
HEAT PUMP & AIR CONDITIONER 3-15 TONS
u•ia.,.ak.0ON 01015 ER 0 fON S
HEAT PUMP & AIR Ct4DffIONER 30-50 TONS
HEAn:NDIi'IONEf1;1`SQ;TONS :
VENTILATING FANS
EVAPO11#111 , ,QOLERS -.
TYPE 1 HOOD (PER 12' OR 12' PIN. OF HOOD)
.: 6
T1'PEiTi _ z .
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS QCT COVERS ELSEWHERE
UNLISTED GAS APPLIANCE <400.000 ElTU
ULNSTED GAS APPUN CE a BTU
USED APPLIANCE <400.000 BTU
USED APPLIANCE a BTU
AIR nANDLER <10.000 CYIa
AIR HANDLER >10.000 CFM
X EACH
UNIT
= AMOUNT
2
x 10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.03 =
x 1.00 =
x12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x25.00 =
x 35.00 =
x60.00 =
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 =
14
12.nn
2.00
NOTE: MINIMUM PERMIT F E 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