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1992, 11-18 Permit App: 92010160 Mechanical Fixtures
(kS064 c3•ccQc5 L p - 2 n ccto,, 4-03 ' ^I MI`CHANICA L PERMR-APPUCATION FORM •- L Information Worksheet " _ . - E. JOB STREEiAODRr�; ""a dlOb E Kora ea au_ GIT'/STATEmys_ -• L o_. . PARCEL NUMB. ER: OWNER: -- PHONENUMBER:` 4t4-4510 MAILING ADDRESS: ID\Db E goat (Street) "Sturm Heating, Inc. CONTRACTOR: > _ 204 Indiana MAILING ADDRESS- - -(Street) (City/State) (Lp) LICENSE NUMBER: STUR11I{" 210 QF PHONE NUMBER: 325-4505 Spokane WA. (City/State) MECHANICAL WORKSHEET (FEE SCHEDULE DESCRIPTION - ELECTRIC/DUCTWORK (SEPARATE SYS 1 EMS) GAS EOUIPMENTf100,000 BTU DUCTWORK) •GA,� SJ:11, NG WT < - ,F t i fi; i4i� o^,. BOILERIREFRIG 1-100M BTU • G1LF_R713E iti.-ce6MS Uh �va'�1 BOILERIREFRIG 501-1,000M BTU 9GILIERLB BOILERIREFRIG+1,750M RTU F�Tdp� M(3%&191G©nOWNER SO, TflNS;cin: cr,t HEAT PUMP &AIR GONDRlONER 3-15 TONS LH pCP g 45(GO DN 1TIOPER,75t;30 TO S HEAT PUMP & AIR CONDITIONER 30-50 TONS- , G•n7PUMP33'A`i"�ONDRIONE•31-50'gp VENTILATING FANS AP,ORgr-I, TYPE I HOOD (PER 12' OR 12' PIN. OF HOOD) CLOTHES DRYER- :Q6NGE i•`^ir=s 0..te91, _ ,215 ir- 'e,�K:�;- i'r% S� ,a ti*.nv':R^.�..w>f£;1.:.�.ii-..� � '.f' � �Mi`ifr� $;:i:i�,W GAS LOG - -(rSCE`Sti CU SOT.+O3v.EA",FDIMEWy%REk4 UNLISTED ED GAS APPLIANCE <400,000 BTU - G 71Rj- 1 1�NC[;00m00j87U, L1�S�Efl� USED APPLIANCE <400,000 BTU SEDitaI1AM >etW0.0 AIR HANDLER <10.000 CFM ' IfilI ANOt1✓RJ10;3°CFp.17-7. * Fur nate_ NOTE: MINIMUM( PERMIT FEE Is s3s.oa SIGNATURE_ 99207 Pp) NUMBER OF UNITS X EACH UNIT =AMOUNT x 10.00 = x 25.00 = x 10.00 = x 12.00 = 1 12..00 x15.00 = x 1.00 = I,OO x 12.00 = - x20.00 =-- x25.00-_;- x35.00 =- x 60.00 = - X 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 10.00 = x10.00 = x 50.00 = x 10.00 = x10.00 = x 10.00 = x10.00 = x10.00 =" x 50.00 = x100.00 = x50.00=. x100.00 =..- • x12_00 = x 15.00 = SUBTOTAL S PLUS: PROCESSING FEE" • +- S 25.00 EQUALS: TOTAL PERMIT FEE OUE _s 3S,bitt