1992, 06-12 Permit App: 92004279 Mechanical Fixtures)I 7 frNi
L
JOB STREET ADDRESS:
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
S. 4308 Pondra
s t1
CITY/STATE/ZIP: Spokane, WA 99206
OWNER: Frank Chervenko
MAILING ADDRESS:
PARCEL NUMBER:
PHONE NUMBER:
(Street) (City/State)
CONTRACTOR: Inland Heating & Cooling LICENSE NUMBER:
SUNLOI(107J6 (Zip)
SUNLOI101JB
PHONE NUMBER: 455-4147
MAILING ADDRESS: 3655 Government Way Coeur d'Alene, ID 83814
DESCRIPTION
(Street)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
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
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,0001 1,750M BTU
BOILER/REFRIG +1,750M BTU
•HEAT PUMP<& AIR: CONDITIONER 03 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT;PUMP & AIR _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 1CNOOD .
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPUANCE <400,000 BTU
UUNSTED GAS APPUANCE >400.000 BTU
USED APPLIANCE <400,000 BTU
USED APPUANCE >400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM;
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 =
x 50.00 =
x100.00 =
x 50.00 =
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