1993, 05-19 Permit App: 93003742 ACMECHANICAL PERMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: N 101 Clinton
4 3 s
#7159
5-18-<3
CITY/STATE/ZIP•Spokane Wa 9921G PARCEL NUMBER:
OWNER:_ Mrs Ennana PHONE NUMBER: q2.6-0324
MAILING ADDRESS: same
CONTRACTOR:
(Street)
Sturm Heating
MAILING ADDRESS: E 204 Indiana
DESCRIPTION
(City/State)
LICENSE NUMBER:
(Zip)
STURMI*210QF
PHONE NUMBER: 325-4505
Spokane Wa
99207
(Street) .. (City/State)
MECHANICAL WORK
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
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GAS WATER HEATER
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GAS EQUIPMENT +100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 501-1,000M BTU
_TAMci3;T:,
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 3-15 TONS
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ow
HEAT PUMP & AIR CONDITIONER 30-50 TONS
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ig
VENTILATING FANS
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. 174�
TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD)
CLOTHES DRYER
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GAS LOG
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UNLISTED GAS APPLIANCE <400,000 BTU
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USED APPLIANCE <400,000 BTU
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AIR HANDLER <10,000 CFM
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NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x25.00 =
x 10.00 =
x12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x.35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x25.00 =
x 35.00 =
x60.00 =
x 10.00 =
x 10.00 =
x50.00 =
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 =
12.00
SUBTOTAL
$ 12.00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
37.00
=$