1992, 08-03 Permit App: 92005981 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Infornation Worksheet -d1DRA pU! = S tPJI
'B2 LI/
/2/
JOB STREET ADDRESS: S. 4203 Pondra
CITY/STATE/ZIP: Spokane, WA 99206
OWNER: Joseph Stafford
PARCEL NUMBER:
PHONE NUMBER: 927-9803
MAILING ADDRESS:
(Street)
CONTRACTOR:Inland Heating & Cooling
MAILING ADDRESS:3655 Govt. Way, Coeur
(Street)
(City/State) SUNLOI107J6
LICENSE NUMBER:SUNLOI101JB
(Zip)
PHONE NUMBER: 455-4147
d'Alene, ID 83814
(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
601140/R3001. 101 -500M BTiI
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,0001.1,750M BTU
BOILER/REFRIG +1,750M BTU
HEAT PUMP -A RP CONDITIONER 0.S TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
CONDITIONER I 0 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PI IIAP„ . CONDITIONER +50 TONS .
-VENTILATING FANS
EVAPORATIVEOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE1110Oa ` -,
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400.000 BTU
UUNSTED GAS APPLMAI E >400000 BTU
USED APPLIANCE <400.000 BTU
USED APPLIANCE >Klux VTU
AtR HANDLER <10.000 CFM
AIR HANDLER >10,000 CFM
(Zip)
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 =
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 =
x50.00 =
X100.00111
x 50.00
100.00-
x50.00
X100.00 =
X 12.00 =
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
49.00
=$
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675