1992, 09-17 Permit App: 92007765 Mechanical FixturesMECHANICAL &4iHMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: 5023 N. Lucille
CITY/STATE/ZIP: Spokane} WA 99216
OWNER: Arleen Rauscher
PARCEL NUMBER:
a---/-7@5
3x-79
PHONE NUMBER: 924-7810
MAILING ADDRESS:
(Street)
CONTRACTOR: Inland Heating & Cooling
(City/State) SUNLOI107J6 (Zip)
LICENSE NUMBER: SUNL01101JB
PHONE NUMBER: 455-4147
MAILING ADDRESS: 3655 Govt. Way 1112 Coeur d'Alene, ID 83814
(Street) (City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT
= AMOUNT
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS EQUIPMENT <100,000 BTU (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET) '. .
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG101' -500M BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,0001-1,750M BTU':_
BOILER/REFRIG +1,750M BTU
HEAT:-PUMP:&'AIR_CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT CONDITIONER€15-30'TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
:N4TPUMP$4RCONDITIONER.+50 TONS
VENTILATING FANS
EVAPORATIVE;DOLERS :.::
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE 1I1i0 ie r
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNUSTED GAS APPUAP CE <400.000 BTU
UUNSTED GAS APPLIAICF >400=0 STU
USED APPUANCE <400.000 BTU
USED APPLIANCE 14=00 BTU
ArR HANDLER <10.000 CF1A
MR HANDLER >10,000 CFU
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 $35.00
SIGNATURE
Sa„di,
SUBTOTAL
5 24.00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=5
49.00
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675