1992, 09-04 Permit App: 92007206 Mechanical Fixtures(oOC,2 2-t`11'I q L rB (
45oa 'C k (0 J MECHANICAL PERMIT APPLICATION FORM
'(R Tu � Deo,* Intor.-nation Worksheet
JOB STREET ADDRESS: 4704 N. Lucille
CITY/STATE/ZIP: Spokane, WA 99216
PARCEL NUMBER:
OWNER: Arthur Johnson PHONE NUMBER: 928-3839
MAILING ADDRESS:
oc,
(Street)
CONTRACTOR: Inland Heating & Cooling
MAILING ADDRESS: 3655 Govt Way
(Street)
(City/State)
LICENSE NUMBER:
PHONE NUMBER:
Coeur d'Alene,
(City/State)
SUNLOI101JB
SUNLOI107J6
455-4147
ID 83814
(Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
OF UNITS
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVEANSERT
GAS WATER HEATER
GASEQCIIPJAEN;T"r100:000 BTU:(INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
BOILERIREFRIG 1-100M BTU
.... . .. ...
010tO EWS01`4,,40M:$TY]
BOILERIREFRIG 501-1,000M BTU
8101REt10:400)41), OM'B7'ki
BOILER/REFRIG+1,750M BTU
HEAT i'. ,1� * "GONO$$ JONER 0=3,7'ONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
X EACH
UNIT
= AMOUNT
'1.1EE1,: a r GON1151NR CS41 ,ONS;
HEAT PUMP & AIR CONDITIONER 30-50 TONS
;ti ( t �COND►1iON00916604f4 :
VENTILATING FANS
EVAPOlVit :0 OLERS
TYPE I HOOD (PER 12' OR 17 PTN. OF HOOD)
TYPE9f ...Wr;
CLOTHES DRYER
GAS LOG
MISCELLANEOUS (NOT COVER® BSEP
UNLISTED GAS APPiJAPlCE <400= ETU
UUNSTED GAS APPUANCE >400= OW
USED APPLIANCE <4110A00 BTU
USED APPLIANCE >4=00 ITN
AIR HANDLER <10.000 CFU
AIR HANDIER >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 -
x 50.00 -
x100.00 -
x 50.00 -
x100.00 -
x 12.00 =
x 15.00 =
10.00
12.00
2.00
NOTE: MINIMUM PERMIT FEE IS 135.00
SIGNATURE t
SUBTOTAL
1 24 00
PLUS: PROCESSING FEE
t 1 25.00
EQUALS TOTAL PERMIT
FEE DUE
49.00
=5
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675