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1991, 11-25 Permit App: 91008159 Mechanical FixturesMECHANICAL PERMIT APPLICATION FORM Information Worksheet JOB STREET ADDRESS: East. 7623 South River Way. CITY/STATE/ZIP: Spokane. WA 99212 OWNER: Mrs Theo Egan PARCEL NUMBER: PHONE NUMBER: 926-7235 MAILING ADDRESS: East 7623 South River Way Spokane, WA 99212 CONTRACTOR: (Street) Sturm Heating, Inc. MAILING ADDRESS: E• DESCRIPTION 204 Indiana (Street) (City/State) (Zip) LICENSE NUMBER: STURMI* 210 QF PHONE NUMBER: Spokane WA. 99207 (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) WOODSTOVEI'II01E.:::::.. GAS WATER HEATER . GAS EQUIPMENT+100,000 BTU DUCTWORK) GAS PIPING {EA OUTLET) BOILER/REFRIG 1-100M BTU BOILER/REFRIG 501-1,000M BTU ilfOraWfakpmmazgogig BOILER/REFRIG +1,750M BTU HEAT PUMP & AIR CONDITIONER 0 3 TONS HEAT PUMP & AIR CONDITIONER 3-15 TONS NEAT PUMP <A!R CONDDITIONER T5 30 TONS HEAT PUMP & AIR CONDITIONER 30-50 TONS >HEAT PUMP &AIR CONDITIONER +50 TUNS VENTILATING FANS TYPE I HOOD(PER 12' OR 12' PTN. OF HOOD) CLOTHES DRYER. GAS LOG UNLISTED GAS APPLIANCE <400,000 BTU xrcx:.-rxr::a-,�c---,�rr:.;c�c,•.,,,:,- -rw.,v.,.•::.,w.r.»,,:...,•:. -:: USED APPLIANCE.<400.000 BTU AIR HANDLER <10.000 CFM f+uSnYY{-w.,,�v:: y,.vY�{{i:`ii::r{:-`.�5`.}^•l:-{Y.S,.�'Y.:? NOTE MINIMUM PERMIT FEE IS $35.00 SIGNATURE NUMBER OF UNITS X EACH UNIT = AMOUNT x 10.00 = x25.00 = x 10.00 = x 12.00 = x 15.00 = x 1.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x60.00 = x 12.00 = x20.00 = x25.00 = x35.00 = x 60.00 = x 10.00 = x10.00 = x 50.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x 10.00 = x 50.00 = x100.00 =• x50.00=. x100.00 = x 12.00 = x 15.00 = 1 15.00 1 1.00 > ,.- - 4. • SUBTOTAL $ 16.00 PLUS: PROCESSING FEE + $ 25.00 : EQUALS: TOTAL PERMIT FEE DUE 41.00 _$ Spokane County Division of Buildings