1992, 09-14 Permit App: 92007588 Mechanical Fixtures 3505 ��4�
L-‘ 3.3-a . MECHANICAL PERMIT APPLICATION FORM 9 ` -15E1n.a ec wc, a
y� Inforna ion Worksheet
JOB STREET ADDRESS: 3 905 S k i p w n r t h ' l I
5 7
CITY/STATE/ZIP:s ti n k an_e_,, ti A c g 7 n y PARCEL NUMBER:
OWNER: Larry Damm PHONE NUMBER: 92'i 685-8
MAILING ADDRESS:
(Street) (City/State) S UNL 0110 7 3 6 (Zip)
CONTRACTOR:Inland Heating & Cooling LICENSE NUMBER: SUNLOI101JB
PHONE NUMBER:_ii 55-414_7
MAILING ADDRESS: 3655 Govt . Way Coeur D 'Alene , ID 83814
(Street) (City/State) (ZP)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
DESCRIPTION OF UNITS UNIT =AMOUNT
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 =
WOODSTOVE/INSERT X 25.00 =
GAS WATER HEATER 1 x 10.00 = 10 .0 0
GI1Sh IP,0141T"100.000;0h(INCLUDES x 12.00
GAS EQUIPMENT+100.000 BTU DUCTWORK) 1 x 15.03 = 1 5 . 00
. ::..... >•.: h< :Y 2 x 1.00 = 2 . 00
BOILERIREFRIG 1-100M BTU x 12.00 =
, . ..Y .«.�M.:. .:. . x 20.00 =
I E � 40.0 i'8T? ril�:V..vs.wt Y .
BOILER/REFRIG 501-1.000M 8TU x 25.00 =
1,0001. ;'1.5(M '« x 35.00 =
'GCSS� G 8TU Y ; :
BOILER/REFRIG+1,750M BTU x 60.00 =
,. <,.<«;..:.A•;�-..;:r::., r x 12.00
EAT ' O 1R ,ONE#w.n NS.. ..
HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 =
�,�,. .Y..,...,:...:r:.,. x 25.00
' OND��.`,....ONER `>�,�,,,r..ONS =
HEAT PUMP&AIR CONDITIONER 30-50 TONS x 35.00 =
�.]:.�< :..:. .b ,�E.. x 60.00
:H 'k�i' 7W I�:�
°����� ND'�'lON..R50�'ONS _
'VENTILATING FANS I x 10.00 =
x 10.00
0.40:117431:: . . L.ERS:::::' : . _
TYPE I HOOD(PER 12'OR 12' PTN.OF HOOD) x 50.00 =
TYPE ' ;.: _.. :x x 10.00 =
CLOTHES DRYER x 10.00 =
RANGE.- . .. x 10.00 =
GAS LOG x 10.00 =
MISCBLANEOUS(NOT COVES ELSEVMERE x 10.00 =
UNLISTED GAS APPUMICE<400.000 BTU x 50.00 =
UIJ4STEED GAS APPLIANCE>400.000 BTU x100.00=
USED APPLIANCE<400.000 BTU x 50.00 =
USED APPLE> 401:1OTU ' x100.00=
t.
AIR MANDLEA in 0.000 CFm I 1 x 12.00 = I
AIR HANDLER>10.000 CFU x 15.00 =
SUBTOTAL $ 27 . 00
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT 52 . 00
FEE DUE ='S
SIGNATURE -' '
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA. 99260 (509) 456-3675