1992, 12-04 Permit App: 92010658 Mechanical FixturesMECHANICAL. PEPMI: APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: 77'10 Cheryl C t. �
CITY/STATE/ZIP: Spokane , WA 99037 PARCEL NUMBER:
OWNER: Steve Streich PHONE NUMBER: 928-1541
MAILING ADDRESS:
(Street)
CONTRACTOR Inland Heating & Cooling
MAILING ADDRESS:
(City/State) SUNLOI107J6 (Zip)
LICENSE NUMBER: SUNLOI101JB
PHONE NUMBER: 455-4147
3655 Govt. Way //12 Coeur d'Alene, ID 83814
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
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
B01,LEFR/gEFRIG101-5p0M'BTU
BOILER/REFRIG 501-1,000M BTU
BOILERFREF.RIG 1;0001-1,750M BTU
BOILER/REFRIG +1,750M BTU
HEAT Pt1 : P :; 1I11 CONDITIONER 0- TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
#1FAT?UMP58`s iR GOND1 1ONER y5 -3O TONS'
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT -Pt 4110, & OONDIT1ONER'+SO TONS
•VENTILATING FANS
EVAPORATIVEOQOLERS
TYPE 1 HOOD (PER 12' OR 12 PTN. OF HOOD)
<:m -
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVEN
UNLISTED GAS APPLIANCE <400.000 BTU
UL1 STED GAS APPuAN >E >400.00p BTU
USED APPLIANCE ��400,000 BTU
USED APPLIANCE X00 BTU
A rR HANDLER <-10.000 Cts
AIR HANDLER >10.000 CFI4
NOTE: MINIMUM PERMIT FEE IS 535.00
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
1
1
2
I
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
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
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
15.00
2.00
SUBTOTAL
S 27.00
PLUS: PROCESSING FEE
. $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
52.00
=5
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675