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1991, 07-25 Permit App: 91004484 Water HeaterMECHANICAL PERMITA.PPLICATtON FORM Information worksheet JOB STREET ADDRESS: East 8610 Mission Src?- CITY/STATE/ZIP: Spokane, Wa.. 99212 OWNER:OWNER:Kieth Hollenback MAILING ADDRESS: Same PARCEL NI IMBER: / �.� ( - d Si • PHONE NUMBER: 924-5484 (Street) CONTRACTOR: Sturm Heating, Inc. MAILING ADDRESS: E. 204 Indiana (City/State) (Zip) LICENSE NUMBER: STURMI* 210 QF PHONE NUMBER: r Spokane WA. 99207 DESCRIPTION (Street) ,` (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER OF UNITS (Zip) X EACH UN(T =AMOUNT ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) sVJOODSTOVELINSERT; GAS WATER HEATER 6AS'EQ01P(t1EWRIe 00,007 BTU {iISCLUDES__`_ GAS EQUIPMENT+100,000 BTU DUCTWORK) GAS PIPING,(EA.GUILET) . BOILER/REFRIG 1-100M BTU BOIL R/.REFRIG.`i0.1:-500M BTU . BOILERIREFRIG 501-1,000M BTU ^_;-:.._a...,..... .. . { ETU �TU BOILER/REFRIG +1,750M BTU HEAT PUMP &'AIR'.CONDITIONER 3TONS BEAT PUMP & AIR CONDITION _F 2-15 TG'\S .HEAT,P.UMP'S AIRCONDITIONER 15-30 TONS HEAT PUMP &AIR CONDITIONER 30-50 TONS 11EAT P;UN,P_ &�� I,R:CONOITION ER +SO TONS VENTILATING FANS EW FORATiV.EiCOOLERS; . .. - - TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) CLOTHES DRYER. --. -- GAS LOG ?f ISCELtANEOUS.'(NOT`COVERED ELSEWHERE UNLISTED GAS APPLIANCE <400,000 STU ;ULINSTED GAS APPLIANCE>400,000 BTU USED APPLIANCE <400,000 BTU t)SED ,kF't'l 11 INCE X100,000 13TU AIR HANDLER <10,000 CFM 'htf1111ANDLER >10;000 CP,{ ; NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNA.I UI;I_ 1 x 10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x 1.00 = x 12.00 = x20.00 = I x 25.00 = x 35.00 x 60.00 x 12 00 20.00 x 25.00 = x 35.00 = 1 x 60.00 = x 10.00 = x'10.00 = x 50.00 .- x x 10.00 = x10.00 = 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 = SUBTOTAL PLUS: PROCESSING FEE 10 DUALS: TOTAL PERMIT FEE DUE Spokane County I)ivi';inn n( (iuilrlinrn- 35.0