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