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1993, 05-17 Permit App: 93003640 AC
MECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: S 3808 Loretta 3Coge #713 5-14-9 CITY/STATE/ZIP. Spokane Wa 99206 PARCEL NUMBER: OWNER:..ck Fisher PHONE NUMBER: 927-8834 MAILING ADDRESS: same CONTRACTOR: (Street) Sturm Heating MAILING ADDRESS: E 204 Indiana DESCRIPTION (City/State) LICENSE NUMBER: STUEMI*210QF (Zip) PHONE NUMBER: Spokane Wa 325-4505 99207 (Street) . (City/State) MECHANICAL WORK ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) {...•.,:;:..?.,•:•r•::.:::•::::.:•:;:.;-.::•::?:::;{::•r:.-:Jry:.y. .:t:;�c�{.r..,,a�-3�.r•.. .. .:...-:•.nr<S:;Yt`:`: ,WVOOOSTOV !(NSgt T ':w.:� �..:.�:.,,w.....1,...x`''::' :```'::i' ,:..: n:.i..:. GAS WATER HEATER ::: Myl:.:•.rxw^y:.`^yv^:y::?r:iv:!:.v:?:{!ii'^:•-}vvv..{r:,`: s..: : BTU:' I.:tw#145A �v:n:V vrnW,v: rvmNv-x.+vmv..•xn•:nwmnvrh..n .va nrmh.:v.,.n•m GAS EQUIPMENT +100,000 BTU DUCTWORK) fy.,,v.�c•::.,;{..y.,::,;:....::.y:.•:.....:...:..::-.,.y::.:.....: ::,,�N. :A•,,,,:•;f�-°>r}''-,'"ia:r?"y.;v'�:^'ryq...y:..,ye:o:64'.`'94t'i .o{::o'-...ky ?t`;:-.. Citi:;-t:y:.;`:'Si{`::;;::Z:: %a.•.'':�t{>tii:��: •.,.v<a,-..:•y.,iaaR,,.yy::,�w... :. s:�.c,,,,..v:.•: ;:a.:-:awliA-,:..�:cw:;•:tia.{,:ac:viu•::i '';,::kwaacur:,-: BOILER/REFRIG 1-100M BTU I){e�� .,7/ 17 ,�•..>.... :.. it.`•::`.:'F`.:::-t' ii5yn v:'$;�<:�:c�'$'{:o?off`-.Y� �.y •.•)'V'}:''iiixi i' 'ni{'\:ti.:j'.'--.v-.�$:y'.\r: y-`:i�; x:�:.t,•..•r.•y.„;•«.:-y::.v,.,-: •v.a.:.x..,-n,.:w�..,��.�.: a..a•� ,.,kc,�.\i�.�k:�',:L,Ja•.G,.,...�.:,-.a-ew"oE.a . BOILER/REFRIG 501-1,000M BTU TU.,.:. <B. � �� �:y�:�>y ;1�1G»1:0.04:x.::. :�. M::.... . y:•y::Q���iw .( i�7 ��i.::,,??•: y:•:;•:>�:...:.•.�.x �,KK:.wr.a,..-:.,..,.,o.,, .,w.. BOILER/REFRIG +1,750M BTU HT PUMP & AIRSCt�NpQti 0{Ti)CS!«<xs;t. •k•.y..wa,.w..,,:,:;�.,,w.c,�..,.;,a,a,�:. y.,,M,..:,.,..,a -. ..w..:vw�:a.Roi3�aL: int HEAT PUMP & AIR CONDITIONER 3-15 TONS 7�N,�I�.,;C�� HEAT PUMP & AIR CONDITIONER 30-50 TONS p.�v:.v: {!,r:: •:{{::?:{::Y 3 :;r?-}:�•:??{4:C:?:.�?{{x?Y!-}: ir{:i!� �� v{t:i<::.'.m..Nn: :v':r?�.ii r vii w {{!^i:!�F. F va&:AtRC7vNl VENTILATING FANS 7 /0 1j y� ::r �l 4..�:%t'I4. `v '• r •,d'Sl'.yM S"y4: .':ti:.WCi.:}:. Lyfif%' v;�iJC0. i •'rri:v-. ':i:-R;A;v..4:A•x::-:vvvm:ii.•Y.J:v: iynv:-y:: ivi-ii:. .:1C3!:v3.:,}):i::?:.: r\A:Tr:{rv�Q.M:S•RG'}v+v TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) y)�{:v ?.`•?::3'-:,'J....:-: v: v•':•: {:i:.•_ .x :v ;Y •.ti: ti`i ?::::fi:?:v: nvv-nnv.. )A-;'.{,-.•:ivi:�?%i•:v:.t•.v:iw:v.^yi:Y.vvy:?•yy:?• :!vi•RMv{xvR•:rm\vAvv :ik•:4i:r4i"W CLOTHES DRYER rs ''''S !{.y: •t`f•;.?.:k:`S> :2:`:s"c�'i�. Y..y::y.��{.:,{...y,... TS1yY::v"wJiFi4v}i:•.L::y Vx+'vK{:ti:Y.?�W1: n':nCtiv:{{2.',Os�`yYiLv�+%V. GAS LOG Bxnvw Mmvv:v::.:w::.;::.:•e.yv, nwv:n::,�+.vv+::-:kn�vxnvw.{+v+v!.�;�v:xwr::nr:.vr� UNLISTED GAS APPLIANCE <400,000 BTU USED APPLIANCE <400,000 BTU AIR HANDLER <10,000 CFM NOTE: MINIMUM PERMIT FEE IS $35.00 (zip) NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x 1.00 = x 12.00 = x20.00 = x 25.00 = x 35.00 = x60.00 = x12.00= x 20.00 = x25.00 = 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 = x15.00 = 1 1 19 nn SUBTOTAL $ 12_ nn PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE 37.00 =$ SIGNATURE Spokane County Division of Buildings