1992, 06-24 Permit App: 92004615 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM
Infor.'natior• Worksheet
JOB STREET ADDRESS: 4304 S, Pondra
CITY/STATE/ZIP: Spokane, WA 99206
OWNER: Barbara Bailey
2- LI ti2 L
Coo\
PARCEL NUMBER:
PHONE NUMBER: 928-4 15 5
MAILING ADDRESS:
(Street)
(City/State) S UNLO I 10 7 J 6 (Zip)
CONTRACTOR: Inland Heating & Cooling LICENSE NUMBER: SUNLOI101JB
MAILING ADDRESS: 3655 Gnvt. Way
(Street)
PHONE NUMBER: (5 o9) 455_-4147
Coeur d'Alene, TI) 83814
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVEI:NSERT
GAS WATER HEATER
GAS EQUIPMENTOO,000BTU:(INCLUDES
GAS EQUIPMENT+100.000 BTU DUCTWORK)
GAS PIPINo' EA.OUTI.ET)
BOILER/REFRIG 1-100M BTU
BOI,LIREFAIG i01 -500M BTU
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,0001 1,750M BTU
BOILER/REFRIG +1,750M BTU
.....................
HEAT>PU;MP_&AIR CONDITIONER 0-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
1� EAT P1111.p < A1i CONDITIONER 15.30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT-PUMPr OONDIT1ONER +50 TONS
•VENTILATING FANS
NUMBER
OF UNITS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400,003 BTU
ULINSTED GAS APPUA cE >400.000 BTU
USED APPLIANCE <400,000 BTU
USED APPLE .000 OTU
AIR HANDLER <10.000 Cr iia
AIR HANDLER >10,000 CFM
1
1
2
L
X EACH
UNIT
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 =
x10.00 =
X 10.00
x10.00 =
X 10.00 =
X 10.00 =
x 50.00 =
x100.00 =
x 50.00 -
X100.00 =
x 12.00 =
x 15.00 =
= AMOUNT
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