1992, 09-04 Permit App: 92007203 Mechanical FixturesJOB STREET ADDRESS:
MECH ANICAL PEHMiT APPLICATION FORM
Information Worksheet
4606 N. Lillian
1,---3(0
CITY/STATE/ZIP:21 h
OWNER: P a_t- r i r i a Sullivan
PARCEL NUMBER:
PHONE NUMBER: 9 2 6- 5 8 9 8
MAILING ADDRESS:
CONTRACTOR:
(Street)
. • . .
MAILING ADDRESS:
(City/State) SUNLOI107J6
LICENSE NUMBER: SUNL0I101JB
PHONE NUMBER: 455-4147
(Zip)
3655 Govt_ Way Coeur 4'.A3exc, ID 83814
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
OF UNITS
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GASEQCeNEN� ` 1)0.000 B'TU (INCLI OES
GAS EQUIPMENT+100000 BTU DUCTWORK)
G•zS�!T:::
LE...:...
BOIL ERIREFRIG 1-100M BTU
BOILER/REFRIG 501-1.000M BTU
; ,I F :',;0001L1 75O B
BOILER/REFRIG +1.750M BTU
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
H: ONbtIONEASQ'OS
•VENTILATING FANS
LERS.:;;::::<;:
TYPE I HOOD (PER 12' OR 12' PTN. OF H000)
'TYPE _. :: :meg::;
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT GOWER ELSEWHERE
UNLISTED GAS APPLY/04M <400.000 STU
UUNSTLD GAS A>xPlJAN:E >400.000 STU
USED APPLJANCE <4OOA00 BTU
USED APPUANCE> 1)00 ITU
AIR HANDLER <10.000 CFI,'
AIR HANDLER >10,000 CFU
(Zip)
X EACH
UNIT
= AMOUNT
1.
1
2
x 10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x35.00 =
x 60.00 =
x12.00 =
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 -
x 12.00 =
x 15.00 =
12.00
2.00
NOTE: MINIMUM PERMIT FEE IS S35.00
SUBTOTAL
$ 24.00
PLUS: PROCESSING FEE
$ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=CJ
49.00
Spokane County Division of Buildings
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