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