1991, 07-12 Permit App: 91004174 Furnace, PipingMECHANICAL PERMIT APPLICATION FORM
Information VV'orkstieet
JOB STREET ADDRESS: A 2316 GIRARD RD
CITY/STATE-/ZIP:
WA 99212
OWNER: Bob Revell
MAILING ADDRESS: Same
� a
PARCEL NUMBER:. ! `�
PHONE NUMBER:
924-7608
(Street)
CONTRACTOR: Sturm Heating, Inc.
MAILING ADDRESS: E 204 Indiana
(City/State) (Zip)
LICENSE NUMBER: STURMI* 210 QF
PHONE NUMBER:
Spokane
WA.
99207
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
X EACH
UNIT
x 10.00 =
x25.00 =
x 10.00 =-
1
1 x 12.00 =
x 15.00 =
1 x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x35.00 =
, x 60.00 =
x 12.00 =
20.00 =:
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVEfINSER
Ga_s EQ .fIPMENT <#O0,0OO:OTU {INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (F OUTLET)
BOILERIREFRIG 1-100M BTU
aBOILER/REFRIG 01-5001vf,ti3TU
BOILERlREFRIG 501-1 ,000M BTU
30.1! ER/RE R G `t 000,-1 ,750M Eli'
BOILERIREFRIG +1,750M BTU
?.E; . PU P & iAIR CONDI 1C
R11
. .
,EAI PUMP & AIR CONDITION; -;5 T
HEAL PUMP &>AIR CO1�DiTlOt•i ; 5-30 TO;:S
HEAT PUMP &AIR CONDITIONER 30-50 TONS
HEAT PUMP &.:r.AIR CONDlT1Ot`'ER'-50 TONS
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE 1L:H000
CLOTHES DRYER.
RaNC'=
GAS LOG
:(ISGELLANEOUS (NOTCOVERED'CLSE\HERE
UNLISTED GAS APPLIANCE <400,000 BTU
ULtN!J '. GAS>APPUANCE>400,000 BTU
USED APPLIANCE <400,000 8TU
NUMBER
OF UNITS
(Zip)
;USED PP.IANC1w >400,000,'BTU
AIR HANDLER <10,000 CFM
AlR HANDLER >:10M00;CFM
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 =
= AMOUNT
12.00
1.00
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNAL UI,E
SUBTOTAL
PLUS: PROCESSING FEE
13.00
4- S
25.00
EQUALS: TOTAL PERMIT
FEE DUE
)okane County Division of [3tliIdincy7,
s
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