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1992, 02-12 Permit App: 92000778 Mechanical Fixtures2085 - (� oS 2� C MECHANICAL PERMIT APPLICATION FORM L 0 3 Information Worksheet JOB STREET ADDRESS: 3807 S. Mercy Drive CITY/STATE/ZIP:_ Spokane, WA 99206 PARCEL NUMBER: OWNER: Diane Ragan PHONE NUMBER: 926-3624/ 926-1922 (wk. ) MAILING ADDRESS: Same qD- �S s Sunlok dba CONTRACTOR: inia ■ • ■ - (Street) • • (City/State) (Zip) SUNLOI107J6 LICENSE NUMBER: SUNLOI101JB PHONE NUMBER: (208) 664-4153 MAILING ADDRESS: 3655 Government Way Coeur d'Alene, ID 83814 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER OF UNITS 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/REFRIG 101-500M'BTU BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG 1.,0001-1,750M BOILER/REFRIG +1,750M BTU HEAT PUMP & AIR CONDITIONER 0-3 TONS HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT PUMP & IR: CONDITIONEfl 15-30 TONS. HEAT PUMP & AIR CONDITIONER 30-50 TONS HEATPUMP & AIR CONDITIONER+50 TONS . VENTILATING FANS EVAPORATIVE COOLERS .. . TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD) TYPEI HOOD .. CLOTHES DRYER RANGE GAS LOG MISCELLANEOUS (NOT COVERED ELSEWHERE UNUSTED GAS APPUANCE <400,000 BTU UUNSTED GAS APPLIANCE >400,000 BTU USED APPUANCE <400,000 BTU USED APPLIANCE >400,000 BTU AIR HANDLER <10,000 CFM AIR HANDLER >10,000 CFM, 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 = x 10.00 = x10.00 = x 10.00 = x 10.00 = x 50.00 = x100.00 x 50.00 I. x100.00 x 12.00 = x 15.00 = 10.00 12.00 ?._00 NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE__ ,-- SUBTOTAL S PLUS: PROCESSING FEE 24.00 + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE =S 49.00 Spokane County Division of Buildings woo 1'2(18 Rrnariwav Axton! to Snnkanic, WA QQ2Rf /StlQ) 4_17t