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1990, 07-25 Permit App: 90003521 Heat PumpMECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: S. 1206 Mica Pk. Dr_ CITY/STATE/ZIP: Spokane, Wa., 99206 PARCEL NUMBERIP `/ �-./7 J OWNER: STAN RICHMOND MAILING ADDRESS: Same CONTRACTOR: PHONE NUMBER: 926-3699 (Street) Sturm Heating. TnC. MAILING ADDRESS: E. 204 Indiana (City/State) LICENSE NUMBER:STURMI*210 OF (Zip) PHONE NUMBER: 325-4505 (Street) Spokane, Wa. 99207 (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH OF UNITS UNIT DESCRIPTION = AMOUNT DUCTWORK SYSTEM WOODSTOVE/INSERT GAS WATER HEATER HEATING EQUIPMENT <100,000 BTU HEATING EQUIPMENT +100,000 BTU GAS PIPING (1 - 4 OUTLETS) GAS PIING (5 OR MORE. EACH:) REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) REFRIG 101-500M BTU REFRIG 501-1,000M BTU REFRIG 1,001-1,750M BTU REFRIG +1,750M BTU HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & VENTILATING AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER AIR CONDITIONER FANS 0-3 TONS _ 3-15 TONS 15-30 TONS 30-50 TONS +50 TONS EVAPORATIVE COOLERS TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE II HOOD CLOTHES DRYER RANGE GAS LOG MISCELLANEOUS (NOT COVERED ELSEWHERE) UNLISTED GAS APPLIANCE <400,000 BTU UNLISTED GAS APPLIANCE >400,000 BTU_ USED APPLIANCE <400,000 BTU USED APPLIANCE >400,000 BTU AIR HANDLER <10,000 CFM AIR HANDLER >10,000 CFM 1 x$10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x i, o0 = x 1.00 = x 12.00 = x 20.00 = x 25.00 = 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 = 12.00 NOTE: SIGNATURE MIMUM PERMIT FEE IS $35.00 SUBTOTAL $ 12.00 PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE = $ 37.00 Spokane County Department of Building and Safetx a n� n..�...i...,... A........., n....1._.._ IIA nnncn ie ACC qC7G