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1992, 11-18 Permit App: 92010161 Mechanical Fixtures7 _ �, //-/2-92 MtCI-iANICAL. PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: - 19 210 e r 1onfq ` - _ CITYISTATE(IIP: a t, U - PARCEL NUMBER. OWNER: NE NUMBER: ' C(2(0 - 415-1 Qj PHO • MAILING ADDRESS: ig24 E „Lean+gcmQ/rt (Street) (City/State) -Stumm"r Heating, Inc'- CONTRACTOR: MAtUNG ADDRESS' E. 204 Indiana - (Street) PP) LICENSE NUMBER: STURMI* 210 QF PHONE NUMBER: 325-4505 - Spokane WA_ (City/State) . MECHANICAL WORKSHLLIIFEE SCHEDULE OESCRIFRON ELECTRIC/DUCTWORK (SEPARATE SYS i LMS) eo0.S3Dd 40S0411,...kc GAS WATER HEATER (100,000 BTU GAS EQ 4.11,2 � DUCTWORK) BOILERIREFRIG 1-100M BTU GI aeR1REFFt BOILERIREFRIGG 501-1,000M BTU . 9 GI BOILER/REFRIG 4-11750M BTU ' ,_...�_..., h; RCOJO(-01ER%=3T0NS;,:1�r,.�ay HEAT PUMP &AIR CONDITIONER 3-15 TONS EA7 .�Mp;atANiRIC_O01��I0 Ef3k1-5 Z30�T�Q St=W»5 HEAT PUMP & AIR CONDITIONER 30-50 TONS- , GiM0143bhE EAT. 1OMP - VENTILATING FANS -mac- ; t • TYPE I HOOD (PER 12, OR 12` PTN. OF HOOD)- " - OOD).,,•^- • 1,3,1•50\ .��`-.�,ca.� CLOTHES DRYER. TYPE41 Liao GAS LOG - .S -- ONUS I Ell GAS APPLIANCE <400,000 BTU - .1 Sy 3` ASLRRP1 flNCE;?4I10;�40)87; r <{ 4 Z . USED APPLIANCE<400,000 BTU L <Vi1v ST�II� �{��4•.Zl.'t:�'-.�f t�-'�i`�:�v�! AIR HANDLER <10,000 CFM - 1R1tiAGL1 R :.List_ . --< a• :}.- Furbeia -TCC = - arc, ' rc� NOIL MINIMUM FEE IS S35 00 EQ (,1 j>9.J 1EtV l (VL A /1\) S 71 «E S1G14i,T URE C��_E 99207 CP) NUMBER OF UNITS - X EACH UNIT = AMOUNT X 10.00 = x 25.00 = x10.00 = x 1200 = . - -- 1 l 2.00 - x 15.00 = x 1.00 = x12.00 =. x 20.00 = -- x 25.00 = .-. x 35.00 = - x60.00= -- x1200 = x20.00 = 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 = X10.00 •i ---"'- x -x 50.00 = x100.00= x50.00 = - x100.00 = .- X 1200 = j - I. (» . . -. - - - • . • -- - x 15.00 = SUP6q '.! S t5.OD - S 25.00 = PLUS: PROCES 1NG FEE. EQUALS: TOTAL PERMIT FEE DUE _ S 3s•o0