1993, 05-13 Permit App 93003409 Wtr Htr, Htg EquipL,\Iukl•`ocS
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MECH.AN!CAL PEPMi f APPLICATION FORM
Inior.-nation Worksheet / SUR z,
JOS STREET ADDRESS: E. 14907 Broadway Ave.
CITY/STATERIP: Spo ne, WA 99216 PARCEL NUMBER:
OWNER: Helen Garcia PHONE NUMBER:924-5174
MAILING ADDRESS:
(Street)
CONTRACTOR: Inland Heating & Cooling
MAILING ADDRESS:
DESCRIPTION
(City/State) SUNLOI107J6 (Zip)
LICENSE NUMBER: SUNLOI101JB
PHONE NUMBER: 455-4147
3655 Govt. Way 9112 Coeur d'Alene, Ill 83814
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT
GAS WATER HEATER
GAS EQU!pm tuft' oo,000: BTU (INCLUDES
GAS EQUIPMENT+100.000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG�'101-SOOM 8TU" ,
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG 1 0001 :7 750M BTU "
BOILER/REFRIG +1,7.50M BTU
HEAT PUMP AUR CONDIT1ONER;O-3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEATS?UMPS&WRCONDITIONER`] 30TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEATPIOMa raCONDITIONER +50 TONS'
.VENTILATING FANS
EVAP4R0`0E3001-ERS .
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE`i[M3 bo`
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVERED ELSEWNER£
UNLISTED GAS APPLIANCE c 00.000 STU
ULJNSTS) GAS APPLIANCE >400.000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE>r00A00 STU
ArR HANDLER <10.000 CF1t
AIR HANDLER >10,000 CPU
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
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 nn
2.00
SUBTOTAL
PLUS: PROCESSING FEE
5
24 00
+ S 25.00
EOUALS: TOTAL PERMIT
FEE DUE
=S
49.00
Spokane County Division of Buildings
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