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1993, 04-30 Permit App: 93003083 Mechanical Fixtures�� u'(O sk \S \S� JOB STREET ADDRESS: MECHANICAL PERMIT APPLICATION FORM Information Worksheet North 4708 Larch CITY/STATE/ZIP: Spokane WA 99216 PARCEL NUMBER: OWNER: Simonik, Stanley MAILING ADDRESS: CONTRACTOR: PHONE NUMBER: 208-265-9740 1008 Church Street Sandpoint Idaho 83864 (Street) Steinmetz Heating & A/C LICENSE PHONE MAILING ADDRESS: North 2114 (Street) Pines (City/State) NUMBER: NUMBER: STEINHA147KF (Zip) 509-922-2034 Ste #3 Spokane WA 99206 (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH OF UNITS UNIT DESCRIPTION DUCTWORK SYSTEM WOODST0V4E/INSERT GAS WATER HEATER HEATING EQUIPMENT <109,000 BTU HEATING EQUIPMENT +100,000 BTU .GAS PIPING:(EA.OUTLET) REFRIG 1-100M BTU 4NOT A/C OR HEAT PUMP) REFRIG 101-500M BTU REFRIG 501-1,000M BTU-- REFRIG TU -, REFRIG 1,001-1,750M BTU REFRIG +1,750M BTU HEAT PUMP It HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & VENTILATING AIR' CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER FANS 0-3 TONS _ 3-15 TONS 15-30 TONS 30-50 TONS +50 TONS EVAPORATIVE COOLERS TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE II HOOD CLOTHES DRYER RANGE GAS LOG MISCELLANEOUS (NOT COVERED ELSEWHERE) UNLISTED GAS APPLIANCE <400,000 BTU UNLISTED GAS APPLIANCE >400,000 BTU USED APPLIANCE <400,000 BTU USED APPLIANCE >400,000 BTU AIR HANDLER <10,000 CFM AIR ILANDLER,>10,000 CFM 02 = AMOUNT x$10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = 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 = 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 = (O,Cc 12.00 a.00 NOTE: NIMUM SIGNATURE RMIT FEE IS .00 SUBTOTAL PLUS: PROCESSING FEE $ a9-'00• + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE _$k.9(.o0' S(!0 ane C'unty Department of Building and Safety VLA 1303 Broadwav Avenue Spokane, WA 99260 (509) 456-3675