1993, 05-25 Permit App: 93003911 Heat PumpAbp\
JOB STREET ADDRESS:
a
MECHANICAL PERMIT APPLICATION FORM
12024 E Grace
Information Worksheet
CITY/STATE/ZIP•Spokane WA 99206
OWNER: hg' & Mrs David Haoson
MAILING ADDRESS:12024 E Grace
(Street)
Sturm Heating
CONTRACTOR:
PARCEL NUMBER:
PHONE NUMBER:
S..kane WA
(City/State)
LICENSE NUMBER:
MAILING ADDRESS: E 204 Indiana
DESCRIPTION
PHONE NUMBER:
Spokane Wa
#7183
05/20/93
(zip)
STIMII*210QF
325-4505
99207
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
(zip)
NUMBER
OF UNITS
X EACH
UNIT
AMOUNT
Ey�L,�ECTRIC/(DUCTWORK (SEPARATE SYSTEMS)
R ' St x+r':k. 1`v
GAS EQUIPMENT+100,000 BTU DUCTWORK)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 501-1,000M BTU
I
BOILER/REFRIG +1,750M BTU
0
i303( )_N
HEAT PUMP & AIR CONDMONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
VENTILATING FANS
CLOTHES DRYER
UNUSTED GAS APPUANCE <400,000 BTU
-11:0P' 8rg.0OOta
USED APPLIANCE <400,000 BTU
AIR HANDLER <10,000 CFM
x 1000
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x25.00 =
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 =
$12 CA
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
SUBTOTAL
$ 12.00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$ 37.00