1993, 05-27 Permit App: 93004011 Boiler, PipingJOB STREET ADDRESS:
F
MECH.AN!CAL APPLICATiON FORM
Information Worksheet
CITY/STATEIZI •. tale,' 99 c2 o' PARCEL NUMBER: / ��77
OWNER: / �i 4..e. PHONE NUMBER: 9,2-G Int
MAILING A/RE'S: /
(Street)
CONTRACTOR: Inland Heating & Cooling
MAILING ADDRESS:
(City/State) SUNLOI107J6
LICENSE NUMBER SUNLOI101JB
(Zip)
PHONE NUMBER: 455-4147
3655 Govt. Way //12 Coeur d'Alene, Ill 83814
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
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/REFAIG1 %o1-56om STU., f',... .
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,0001'.-1,750M BTU
BOILER/REFRIG +1,750M BTU
HEAT-PUtp.$';IURCONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEATRU,,MPEtA1R'CONDtri ONER 15 07GNS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEATP,O P$ 'kCONDITIONER:+50'TONS
VENTILATING FANS
..... ...... .. .
EVAI?ORATIVEC00LERS
TYPE I HOOD (PER 12' OR 12' P114. OF HOOD)
TYPE U itOOD` �` ,.
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED QSEWHERE
UNLISTtL) GAS APPLIANCE <400.000 BTU
UU NSTH) GAS APP'11AfCE )400.000 BTU
USED APPLIANCE <400.000 BTU
USED APPLIANCE co>.00(ITU
A'tR HANDLER c10.000 CFL ..
AIR HANDLER >10,000 CFM
NOTE: MINIMUM PERMIT FEE IS 135.00
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
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 =
x20.00 =
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
�n
/a
SUBTOTAL
s. /3114;
PLUS: PROCESSING FEE
. 5 25.00
EQUALS: TOTAL PERMIT
FEE DUE
Spokane County Division of Buildings