1993, 06-07 Permit App: 93004351 Mechanical Fixtures4 I e I IN 1..-(-4
u,1-1\A`k Pc‘f., 3- 5
JOB STREET ADDRESS:
MECHAN!GAL P r?MI AFPLtCATiON FORM
Information Worksheet
16518 E. Longfellow
t
1sty
CITY/STATE/ZIP: 5p o k r} @_,-W a 2
OWNER: Tim Horgan
MAILING ADDRESS:
PARCEL NUMBER:
PHONE NUMBER:
(Street) (City/State) SUNLOI107J6
CONTRACTOR: Inland Heating & Cooling,
MAILING ADDRESS:
3655 Govt. Way 4112
LICENSE NUMBER: SUNLOI101JB
(Zip)
PHONE NUMBER: 455-4147
Coeur d'Alene, ID 83814
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
OF UNITS
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOOOSTOVE/INSERT
GAS WATER HEATER
GAS. EQUIPMENT<100.000 BTU (INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING EAOUT
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 101-500M STU .
BOILER/REFRIG 501-1.000M BTU
BOILER/REFAIG 1.0001 1 750M BTU
BOILER/REFRIG+1,750M BTU
HEAT•.PUMP•.&A R.CONDITlONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEATPUMP.&`A1R CONDITIONER 15-30TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT;p,I J+i P CONDITIONER +50 TONS :• •
.VENTILATING FANS
EVAPORATIVEEcOdLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE I H0OD.;<:. .:'
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLNINCE <400A00 BTU
UUNSTED GAS APDL MACE >400A00 BTU
USED APPUANCE <400.000 BTU
USED APPLIANCE >4IM.000 BTU
n(A HANDLER <10.000 CF1.4
AIR HANDLER >10.000 CFid
NOTE: MINIMUM PERMIT FEE IS 535.00
SIGNATURE
(Zip)
XEACH
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
SUBTOTAL
PLUS: PROCESSING FEE
24.00
25.00
EQUALS: TOTAL PERMIT
FEE DUE
=S
49.00
Spokane County Division of Buildings
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