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1992, 02-12 Permit App: 92000780 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: 3616 S. Mercy Court CITY/STATEIZIP:_ Spnkan_; WA 9.9206 OWNER: Rick S.t-eP1p PHONE NUMBER: 926-0329/922-6966 (wk) 5(-f PARCEL NUMBER: MAILING ADDRESS: Same Sunlok, Inc. a6 treet) (City/State) SUNLOI107J6 (Zip) CONTRACTOR:_____lnland Heating & Cooling LICENSE NUMBER: STTN 0T101.TB PHONE NUMBER: MAILING ADDRESS: 3655 Government Way Coeur d'Alene, ID 83814 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOVE/INSERT GAS WATER HEATER GASEQUIPMENT<100,000 BTU (INCLUDES GAS EQUIPMENT +100,000 BTU DUCTWORK) GAS PIPING (EA OUTLET) BOILER/REFRIG 1-100M BTU .................................................................................................... .... BOILER/REFRIG 101 500MBTU 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 PUMP t& ►IR CONDITIONER 15-30 TONS . HEAT PUMP & AIR CONDITIONER 30-50 TONS HEAT PUMP & AiR CONDITIONER +50 TONS VENTILATING FANS EVAPORATIVE COOLERS . TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE Ili HOOD , CLOTHES DRYER RANGE GAS LOG MISCELLANEOUS (NOT COVERED ELSEWHERE UNUSTED GAS APPUANCE <400.000 BTU UUNSTED GAS APPUANCE >400.000 BTU USED APPUANCE <400,000 BTU USED APPUANCE >400,000 BTU AIR HANDLER <10.000 CFM AIR HANDLER >10,000 CFM: NUMBER OF UNITS 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 = x25.00 = 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 - x12.00 x 15.00 10.00 12.00 2.00 NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE SUBTOTAL $ 24.00 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =S 49.00 Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675