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1992, 12-22 Permit App: 92011105 Mechanical FixturesMECITANICAL PERMIT APPLICATION FORM -SSInformation Worksheet { 2n,n�, C� _ JOB STREETADDRE_ ' J (c�ln! J• �1.�15�"(`IsC --._ Grr{ISTATfJZ1P:� ni-1, • (i- C& \ { Q � n ` - - . PARCEL NUMBER: OWNER:_ fid (\iY-4IC.- MAILING ADDRESS. CONTRACTOR: -Sturm (Street) Heating, Inc MAILING ADDRESS- E. 204 Indiana (Street) DESCRIPTION ELECTRtCIDUCTWORK (SEPARATE SYS LEMS) GAS WATER HEATER PHONE -NUMBER: OLOn 5ircV- 4d'1e (City/State) LICENSE NUMBER: L�— PP) STURMI* 210 QF PHONE NUMBER: 325-4505 Spokane WA.. 99207 (CitylState) MECHANICAL WORKSHE1=I (FEE SCHEDULE 0 GS EQUIPMENT 00.000 BTU DUCTWORK) BOILERIREFRtG 1-100M BTU BOILERIREFR(G 501-1 .000M BTU - : - - _ -- - - BOILERIREFRIG +1,750M BTU 1RIC0:.�( ONER%=31TOIS :`< ITP HEAT PUMP &AIR CONDITIONER 3-15 TONS EIiTP�MP &�A RiCON.DITIO...�Rk15r.��`Isr�:;.�r�»s�. HEAT PUMP & AIR COQ ONER 30-50 TONS" CONDI ONEc+80 EAT. OMR VENTILATING FANS- _`>_-. TYPE I HOOD (PER 12` OR 12` PTN_ OF HOOD) CLOTHES DRYER - IV GEx•ck, : `{moi-` < ^ ±-if ":= . -at ; `:yll:Y LK,.Y�''f` itE'•�� ting,_ `,"1..�, GAS LOG - - UNLISTED GAS APPLIANCE <400,000 BTU iL1t�S���As;RRPi��iNCE�?Qt30;�00�87��w�� 4<�C USED APPLIANCE <400,000 81-U AIR HANDLER <10,000 CFM '1RiiTA10 Rvi0<4a03CF1 NO 1 L f.'.itQ(f'U" PE . UT EEE IS S35-00 S SN /U NE — CSP)• NUMBER OF UNITS - X EACH UNIT `AMOUNT x10.00 = x 25.00 = x10.00 = x 1200 = x 15.00 -.- x 1.00 = x x 1200 = . x 20.00 = -- x25.00 = - x 35.00 = - x 60.00 = -- x 1200 = x 20.00 = x 25.00 = x 35.00 = x60.00 = x 10.00 = x-10.00 = x 50.00 = x 10.00 = x10.00 = x 10-00 = x 10.00 = X10.00 ="- x50.00 = x100.00 = x50.00 = - x100.00 =•.- )12_00= x 15.00 = - -. - ( 12 -OCA j .L(D . - • . - - ' - SUBTOTAL S I L + S 25.00 : PLUS: PROCESSING EE` EQUALS: TOTAL PERMIT T FEE DUE = 5� Orb