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1992, 06-09 Permit App: 92004141 Heat PumpEapagostga HEAT PUMP & AIR CONDITIONER 3-15 TONS }iajrkilitr `ff�t ONDiTW:iiE91m5L,3 NS I HEAT PUMP & AIR CONDITIONER 30-50 TONS' EA' ,p MP &' R (AS -.150.-, a- y\q\ MECHANICAL PEIt"NSfTAPP.UCAT1ON FORM • Information Worksheet • ' • JOB STREET ADDRESS= 1 E. 8223 Nora _ G�:ri.:._:::: •..: • . _ •. CITY/STATE/ZIP• 'SrnkanR. WA 99212 PARCEL NUMBER: OWNER- - Mr. Bud Miller PHONE 'NUMBER: ' 922-4635 MAILING ADDRESS: E. 8223 Nora Spokane, WA 99212 (Street) Sturm Heating, Inc. CONTRACTOR: MAIUNG ADDRESS* E 204 Indiana (City!State) (Zip) UCENSENUMBER: STURMI* 210 QF PHONE NUMBER: 325-4505 Spokane WA. 99207 (Street) (City/State) MECHANICAL WORKSHEETIFEE SCHEDULE DESCRIPTION ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) GAS WATER HEATER ECQUIP..ME, ,o0 I DI.. GAS EQUIPMENT+100,000 BTU DUCTWORK) AGq,s IP NG BOILERIREFRIG 1-100M BTU IlikeratarairA2 r .a ®ILER/R '.'I' BOILER/REFRIG 501-1,000M BTU ..: :O LERIRkPR(G�7"2,04.0 `i 750M B7{i'.IL BOILER/REFRIG+1,750M BTU ' c®NolaIG VENTILATING FANS Af',ORSI ERS `aa.1 TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) CLOTHES DRYER. '•ftANG>w ° 0NP-1 „Y' GAS LOG l fitJE pt ;t' OTCOV•ERED.'EiSEW UNUSTED GAS APPLIANCE <400,000 BTU OS e GF1S + I AN:: ';'00,)000 8 al USED APPLIANCE <400,000 BTU SEDIAPPL:100ir>?40Q:OQ0 8; AIR HANDLER <10,000 CFM WRIHANDl $>iAi000 GFM ,,, E' Et;. NOTE MINIMUM MIT FEE IS S35.00 SIGNATURE Cap) NUMBER OF UNITS . X EACH UNfT =AMOUNT - x 10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x 1.00 = x12.00 =. x20.00 =• . -- x 25.00 =..; : x35.00 = x 60.00 = • x12.00 = x 20.00 = x25.00 = x35.00 = 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 =`' x 50.00 = x100.00 =• x50.00=. 3C100.00 =..- X 12.00 = x 15.00 = 1 12.00 . SUBTOTAL $ 12.00 PLUS: PROCESSING FEE ' + $ 25.00' EQUALS: TOTAL PERMIT FEE DUE = S 37.00 Spo(sa'ne County Division of Buildings