1993, 06-07 Permit App: 93004358 Mechanical Fixtures4551 I ,09(8
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VAC ��� MECHAN!CAL PERM�1 AFPLICATiON FORM
(ANN y V Information Worksheet ' � -7 4(1JOB STREET ADDRESS: 4723 Sunnyvale .
CITY/STATE/ZIP: Spokane, WA 99216 PARCEL NUMBER:
OWNER: Richard Koss PHONE NUMBER: 927-2691
MAILING ADDRESS:
(Street)
CONTRACTOR: Inland Heating & Cooling
(City/State) SUNLOI107J6
LICENSE NUMBER: SUNLOI101JB
(Zip)
PHONE NUMBER: 455-41.47
MAILING ADDRESS: 3655 Govt. Way #12 Coeur d'Alene, ID 83814
(Street)
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER
OF UNITS
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS EQUIPMENT <100,000 BTU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GASPIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
BOlLER/REFAIG�0
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1,00014,750M BTU
BOILER/REFRIG +1,750M BTU
HEAT PU;MP.&:AIR CONDITIONER 0-3 TONS
HEAT PUMP.S, AIR CONDITIONER 3-15 TONS
HEAT. UMPS&`f.A1R CONDITIONER15:-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT;PIUMPR„CONDrnnONER 4+50 TONS
.VENTILATING FANS
EVAPORATIVE Oc LERS :..
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE 1I#I Mr :-
CLOTHES DRYER
RANGE ..
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWHERE
UNLISTED GAS APPLIANCE <400.000 STU
UUNSTED GAS APPUANCE >400.000 BTU
USED APPUANCE <A00.000 BTU
USED APPUOJiC>E >400=0 am
AtA HANDLER <-10.Ob0 CF),I
AIR HANDLER >10,000 CFU
NOTE: MINIMUM PERMIT FEE IS S35.00
SIGNATURE
X EACH
UNIT
= AMOUNT
1
1
2
x10.00 =
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 =
x60.00 =
x 12.00 =
x 20.00 =
x25.00 =
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
SUBTOTAL
24.00
PLUS: PROCESSING FEE
S 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=S
49.00
Spokane County Division of Buildings