1986, 03-13 Permit App: 00010047 Heat Pump- /cps& - L (Z C,
-- MECHANICAL PERMIT APPLICATION WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND
I certify that the above information as submitted by me is true and correct and further, agree that all pro-
visions of laws and ordinances governing this type of work, including inspection requirements, will be com-
plied with whether specified herein .or not. The granting of a permit does not presume to give authority to
violate or cancel the provisions of any state of local laws regulating construction or the performance of
•
construction.
SIGNATURE OF
APPLICATION
OWNER OR DATE
Project r f0.0417
Owner's Name Last First MI
Foss John
Project Address (Street Name & Number) 1 i 103 6 0J r2
SS.—Mariam
City
Spokane
State
WA_
Subdivision/ Plat Name
S W OOp Ffjl `f
Assessors 4rcjil # ".Lot
3
Block
Plat #
Applicant
John Foss
Address
S. 1104 Mariam _
City
Spokane
State
WA_
Zip
99206
Phone
928-4773 _
Business Phone
Contractor
Sturm Heating, Inc. _
Address
E. 204 Indiana
City
Spokane
State
WA
Zip
99207
Phone
325-4505
Contact
Carol
License M
ST -UR -MI -210 -QF
Business Phone
25-4505
Describe Work
Install Heat Pump $24.00
Fans
Evaporative Cooler
Hoods
Electric Furnace/Ducts
Miscellaneous
Dryer
Range
Gas Log
Gas Water Htr.
Solid Fuel/Wood Stove
Air Handling Units
0-10,000 CFM
10,000+ CFM
Refrigeration Systems/
Heat Pumps (BTU)1,001-1750M
1-100M9.00
101-500M
501-1,000M
Over 1750M
Compressor
0-3HP
3-15HP
15-30HP
30-50HP
50+HP
Gas Piping
1-5 Outlets
6+ Outlets
Gas Fired Heating System
1-100,000BTU
10,,Z,00+BTU
Sub -total 9.00
Pro. Fee 15.00
TOTAL 24.00
I certify that the above information as submitted by me is true and correct and further, agree that all pro-
visions of laws and ordinances governing this type of work, including inspection requirements, will be com-
plied with whether specified herein .or not. The granting of a permit does not presume to give authority to
violate or cancel the provisions of any state of local laws regulating construction or the performance of
•
construction.
SIGNATURE OF
APPLICATION
OWNER OR DATE