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1992, 09-17 Permit App: 92007773 Mechanical Fixtures.450‘k c `( MECHANICAL F�RMI7APPLICATION FORM 9._1'7 3 •eQ't otic L,a lb. i Inter:nation Worksheet JOB STREET ADDRESS: 4717 N.- Larch (030 CITY/STATE!IP: Spokane, WA 99216 PARCEL NUMBER: OWNER:Jerry Girard PHONE NUMBER: 922 7699 MAILING ADDRESS: (Street) (City/State) SUNLOI107J6 (Zip) CONTRACTORSnland Heating & Cooling LICENSENUMBER:SITNT,fT101J.b PHONE NUMBER: 455-4147 MAILING ADDRESS: 3655 Govt. Way Coeur d'Alene In R3R1a (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOVERNSERT GAS WATER HEATER GAS EQUIPMENTz100,000 BTU (INCLUDES: GAS EQUIPMENT +100,000 BTU DUCTWORK) GASAPING'{EAOUTLETj:;.. .BOILER/REFRIG 1-100M:BTU NUMBER OF UNITS X EACH UNIT = AMOUNT BOILER/REFRIG 501-1,000M BTU .BOILEWREFRIG 1,0001 1:;75OM BTU,<<;;?''::. . . BOILER/REFRIG +1,750M BTU HEAT PQ 1Ff-GONgt]tONEA 0-3:;JONS_`_:: 1; HEAT PUMP & AIR CONDITIONER 3-15 TONS H,FIATAI1_BIW&A1R`CONDITIONER SA(ftONS HEAT PUMP & AIR CONDITIONER 30-50 TONS H4MO1 OM ONDmowER+50 TONS". VENTILATING FANS .EVAPO,MTINOQOLERS . . . TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) ci OW. ;,-. -A :, TYP CLOTHES DRYER RANGE r - ... . GAS LOG MISCELLANEOUS (MOT COVERED ELSEWHERE UNLISTED GAS APPLIANCE <A00,00D BTU UUI STED GAS APPUILICE >4C0m0 STU USED APPUAt4E a$313.000 STU USED APPLIANCE aelt0001371J AIR HANDLER c10.000 CFR AIR HANDLER>10.000 CFM 1 1 2 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 = x 50.00 = x 10.00 x 10.00 = x 10.00 = x 10.00 = x 10.00 = x50.00e x100.00 = x50.00= x100.00 = x 12.00 = x 15.00 = 10.00 12.00 2.00 NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE SUBTOTAL $ 24.00 PLUS: PROCESSING FEE + $ 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