1992, 09-23 Permit App: 92007962 Water Heater, Piping MECHANICAL PERMIT APPLICATION FORM G\ Q.- 1
Information Worksheet
JOB STREET ADDRESS: 14 415 E. Sharp q\
CITY/STATE/ZIP: Spokane , WA 99216 PARCEL NUMBER:
OWNER: Mitchell Alderman PHONE NUMBER: 924-9622
MAILING ADDRESS:
(Street) (City/State) S U N L 0 110 7 J 6 (Zip)
CONTRACTOR: Inland Heating & Cooling LICENSE NUMBER:SUNL0I101JB
PHONE NUMBER:_ 453-4147
MAILING ADDRESS: 3655 Govt . Way Coeur d 'Alene . In 81814
(Street) (City/State) (zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT =AMOUNT
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 -
WOCDSTOVEANSER T .. x 25.00 =
GAS WATER HEATER - 1 x 10.00 = 1 n 00
04,04010401:t000.000•0:1).(INCLUDES x 12.
GAS EQUIPMENT+100.000 BTU DUCTWORK) x 15.03 =
:;.a...,�:...:.. . ... ...�: >.; :} 1 x 12.00 = 1 . 00
BOILERIREFRIG 1-100M BTU
1ly1 >. x
I�^A : ::•:inn+v:.H4mv4hv:.���f:::C:..Y4.4:.wC•ra,....:.T....... ..:....
'
BOILER/REFRIG 501-1.000M BTU X25.00 =
.;�,,,,,,.. A,.,� w.. , �, r °1#'l5('1M ETU¢<
; JL�F. 3 G D001�
. X
BOILER/REFRIG+1.750M BTU x 60.00 =
-::i•.v6+x M• :. •• n.:•�.W.r w:.v:xN:.v:. :.v n}- =
.CONI D,=34'QNS `4 x 20.00 =
HEAT PUMP&AIR CONDITIONER 3-15 TONS
w, ,::.._..::.w.:;0 E10NS x 25.00 =
HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 _
H ,MWA CQNDITl:ONER 50SONS x 60.00 =
VENTILATING FANSx 10.00 =
,�,.:.,:.-: �.�...:....
EV;A'O-I-ERS: :< , x 10.00 =
:. .
TYPE I HOOD(PER 12'OR 12' PTN.OF HOOD) x 50.00 =
TYPE.m 3 x 10.00 -
CLOTHES DRYER x 10.00 =
RANGE x 10.00 =
GAS LOG x 10.00 =
MISCELLANEOUS(NOT COVE ELSEWHERE x 10.00 =
UNLISTED GAS APPLIANCE<400.000 STU x 50.00 =
UUNSTED GAS APPLNIiICE>4OO. 00 BTU x100.00
USED APPLIANCE 40100.000 BTU x 50.00 =
USED APPWNCE>400 STU ` x100.00=
£1R HANDLER<10.000 CFI' i 1 x 12.00 = 1
AIR HANDLER>10.000 CFU x 15.00
I
SUBTOTAL $ 11 . 00
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT E IS$35.00 EQUALS: TOTAL PERMIT 36 . 00
FEE DUE =S
SIGNATURE g- ,
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA. 99260 (509) 456-3675