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1991, 11-15 Permit App: 91007878 Mechanical Fixtures
MECHANICAL PERMIT APPLICATION FORM Information W irkshi:8t JOB STREET ADDRESS: IE. 12011 Frederick CITY/STATE/ZIP; Spokane, WA 99206 PARCEL NUMBER: O 9Sy/ ,r//o OWNER* Mr Ron Clark PHONE NUMBER: 928-4828 MAILING ADDRESS: E. 12011 Frederick Spokane,r<•:WA 99206 (Street) (City/State) (Zip) CONTRACTOR: Sturm Heating, Inc. LICENSE NUMBER: STURMI* 210 QF PHONE NUMBER: MAILING ADDRESS: E. 204 Indiana Spokane WA. 99207 (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) •WOODSTOVE/INSERT >'.`:::,_`.. GAS WATER HEATER G'AS EQUIPMENT<100,000lBTU (INCLUDES' GAS EQUIPMENT+100,000 BTU DUCTWORK) GAS PIPING (EA OUTLET),;: BOILER/REFRIG 1-100M BTU B01lER/REFRIG�7D3„�500M8Tll`:'s:;: s` °:';'' a BOILER/REFRIG 501-1,000M BTU BOILER/REFRIG 7;000Y:-Y,750M-BTU BOILER/REFRIG +1,750M BTU HEAT &AIR CONDITIONER 0-3TONS:. HEAT PUMP & AIR CONDITIONER 3-15 TONS HEAT:PUlate.& AIR CONDITION ER; 1.5-30 TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS aHEAT PUMP &AIR;CONDITION ER +50 TONS:: VENTILATING FANS EVAPORATIVE'COOL`ERS: TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) iTTYFE CLOTHES DRYER. RANGE :.>°;' GAS LOG (MIISGI t> aNEous (00TOOV:04 EESWiliERE:__` ` -;:,, UNLISTED GAS APPLIANCE <400,000 BTU IUL"1NSTED GAS APFI ANCE>400;000 BTU_:" USED APPLIANCE <400,000 BTU 1ISEOWPPIAW.7,00;000 AIR HANDLER <10,000 CFM fA1RHANDLE Y0 0 O:CF'M NOTE MINIMUM PERMIT FEE IS $35.00 SIGNATURE • (Zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x10.00 = x 12.00 = x15.00 = x 1.00 = x12.00 =, x 20.00 = x 25.00 = x35.00 = x 60.00 = x12.00 = x20.00 = x25.00 = x 35.00 = x 60.00 = x10.00 = x 10.00 = x 50.00 = x10.00 = x10.00 = x10.00 = * 10.00 = x 10.00 = x 50.00 = x100.00 = x50.00= x100.00 = x 12.00 = x 15.00 = 1 12.00 1.00 SUBTOTAL $ 13.00 PLUS: PROCESSING FEE + $ 25.00 : EQUALS: TOTAL PERMIT FEE DUE _ $ 38.00 Spokane County Division of Buildings A y