1992, 09-17 Permit App: 92007764 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM 9a --77v(
•-' Information Worksheet• �-a--79
JOB STREET ADDRESS: 5013 N. Lucille
CITY/STATE/ZIP: Spokane, WA 99216
OWNER: Dan Barbieri
MAILING ADDRESS:
PARCEL NUMBER:
PHONE NUMBER: 928-5018
(Street) (City/State) SUNL01107J6 RIP)
CONTRACTOR: Inland lfeatin.g & Cooling
MAILING ADDRESS:
LICENSE NUMBER: SUNLOI101JB
PHONE NUMBER: 455-4147
3655 Govt. Way #12 Coeur d'Alene, ID 83814
(Street)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
OF UNITS
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVEIINSERT.
GAS WATER HEATER
GAS EQUIPMENT<100,900 BTU (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING (EA:OUTLET):_
BOILER/REFRIG 1-100M BTU
BOILER/REFAIG101-5OOM BTll
BOILER/REFRIG 501-1,000M BTU
BOILER/R,EFRIG:.1 0001-1,750M'BTU_ _. >
BOILER/REFRIG +1,750M BTU
HEAT.PUMP B.AIR CONDITIONER 0=3::TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP:& A1R'CONDITIONER 15 0 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT_PUMP 319,9ONDFTIONER+50'TONS
.VENTILATING FANS
EVAPORATIVE'OCILERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TXPE11;0005. - . '
CLOTHES DRYER
RANGE . .
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <4CO.0IX) BTU
ULNSTED Gm APPLIANCE >400,000 BTU
USED APPLIANCE <400.000 BTU
USED APPLWICE BTU
£rR HANDLER <10.000 CPU
MR HANDLER >10.000 CFR
X EACH
UNIT
= AMOUNT
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 =
x10.00 =
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 S35.00
SIGNATURE
SUBTOTAL
$ 24.00
PLUS: PROCESSING FEE
r $ 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