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1992, 09-04 Permit App: 92007188 Mechanical FixturesJOB STREET ADDRESS: MECHANICAL. PERMIT APPLICATION FORM intor..nation Worksheet 4718 N. Larch qa--l►$l i3eba CITY/STATE/ZIP:Spokane, WA 99216 PARCEL NUMBER: OWNER: Don Graham PHONE NUMBER: 927-8L24 MAILING ADDRESS: (Street) (City/State) SUNLOI107J6 (ZiP) SUNLOI101JB CONTRACTOR: Inland Heating & Cooling LICENSE NUMBER: MAILING ADDRESS: PHONE NUMBER: 455-4147 3655 Govt. Way Coeur d'Alene, ID 83814 (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER DESCRIPTION OF UNITS ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOVE/INSERT GAS WATER HEATER 1 GAS: EQUIPMENT2100,000 BTU (INCLUDES (Zip) GAS EQUIPMENT+100,000 BTU DUCTWORK) GAS PIPING_ EAcQUTLET)1: BOILER/REFRIG 1-100M BTU E15104.(440.01:0151444007 BOILERI'REFRIG 501-1,000M GTU :BOILER/REFRIG';'1,0001. I, 50M'G IJ BOILER/REFRIG +1,750M BTU HEATvPu P 1„Ff--CONDI7IQNE13,0-3;TONS: HEAT PUMP & AIR CONDITIONER 3-15 TONS H -E#1 4_IP bA1R'GOND1;rfPNER1:SESTONS HEAT PUMP & AIR CONDITIONER 30-50 TONS HEATFI MP'4 CO$0Iti0NEA+50TQNS . ' VENTILATING FANS EVetCS ATn/E„ 3OLERS.::.:. TYPE I HOOD (PER 12' OR 17 PTN. OF HOOD) TYPE UIt30D CLOTHES DRYER RANGE GAS LOG MISCELLANEOUS (NOT COVERED UNLISTED GAS APPLIMNCE <400.000 BTU ULR4STED GAS APPLIANCE MOO. OD BTU USED APPLIANCE <400000 BTU USED APPLIANCE )41213A100 BTU ArR HANDLER <10.000 CFN AIR HANDLER >10.000 CFU X EACH UNIT = AMOUNT 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 = x50.00 = x100.00 - x 50.00 = x100.00 - 1 x 12.00 = x 15.00 = 10.00 12 00 2.00 NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE gr 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