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1991, 10-14 Permit App: 91006795 Mechanical Fixtures I • > . MECHANICAL PERMIT APPLICATION FORM• .••. :::::. ': : . • Information Worksheet • • ; 0 41 1 JO8 STREET ADDRESS: S. 4223 Sunderland Road • , Q 1 CITY/STATE/ZIP: Spokane WA 99206 PARCEL NUMBER: • OWNERMr and Mrs Mike Butler PHONE NUMBER: 924-9419 MAILING ADDRESS:. 4223 Sunderland Road Spokane, WA 99206 (Street) (City/State) (Zip) , CONTRACTOR: Sturm Heating, Inc. LICENSE NUMBER: STURMI* 210 QF PHONE NUMBER: 325-4505 MAILING ADDRESS: E. 204 Indiana Spokane WA. 99207 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = W4viO.\ tv .. . mu,, xtixnn . n ,nh. x 25.00 • GAS WATER,HEATER - - . 1 x10.00 = 1 0 . 0 0--• • IAS€EQ>1l:Pl IEIET P30,(00 l3TU(INCLUDES n r 1 = 12 0 0 �:,.::x �..:.,,.,x,.,,,�:::K,,,,,,,,,,,,,,;,, , .....;.... :.,:.. ........ ..:. x 1200 GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = • :::0UTLE':: :::::::>:::::]*:ii»:x„::;::u,.,„> ::.-,.....>>>>:»:; :::..�,..,.:::.:�::' :GAS:<P:IP:..,..,G;( < ::•.:;;•::::w <.:*::::.:<::•::;:.;::;.:;moi:i;<K<:::;>>:<s:<: >:r>::»:<:>::r:»»:<:«:E 3 x 1.00 = 3 . 0 0 BOILER/REFRIG 1-100M BTU x 12.00 = • K3 gRIl3ERRIG:;1.D.1 ..............v......... = .::: ..............:.:.:..� - x2000 ,; • • BOILER/REFRIG 501_-1,000M BTU . . gg_j' R/RE R .a .r..........................: ::.�:.:.:....... x 35.00 = -BOILER/REFRIG+1,750M BTU x 60.00 = .. fET`P;UP& <CD( ONC '0-3TQl : x 12.00 = 1-EAT• PUMP &AIR COND,ITIONE. R-3-15-TONS' ..... i x 20.00 = 1 !-HEAT`PUMP&AIR GON.D}iTIONER 1 S -30.51i6N5 ';�: :..::::...::.:::.:::;:.:.:.....a...� x 25.00 = __.1 HEAT PUMP &AIR CONDITIONER 30-50 TONS • I x 35.00 = - :HEAT PUMP&A9R CONDITIONER+50 TONS :: . .: .,a,wa,..>.,._,::,:..: .,w,... .,...v ..<,.:. ,,....... ..::..... ::.:::; x 60.00 = • VENTILATING FANS x 10.00 = YSnYtiO.,},.Rv3.4•hAJnnVFQOnn.LE. . X1 O.00 _ , TYPE I HOOD(PER 12'OR 12' PIN_ OF HOOD) x 50.00 = :xny:rw }.;�;�:y'�':�?{:,'.•::;.�:(:Qiii:?i:`:�:?:{:?:i;:.� ; 5}} ?:!<C ..Y?} r:4`v"':ii:;i-fi::}:%^??:{:Jii::?,.:::::::u»:,.:; ::>::: :4}::to::<:.::j t•:::,`!i Y:-}:?:`::'. ARE OD:.::a. CLOTHES DRYER. x 10.00 = ;RANG- ,w,.,- -., a:, .-:..>, x 10.00 = GASLOG1 x 10.00 = 10 00 r_��,< T1EO.US'v OT CO;VERED<E' ;.:-a,;.vw,..,,,..,,,a,,,::;:.::;,,:;,.::..,,,. .,,:, ...a,:�:::.�r.::�...:::. ;:...:....a:.:r;..:.........: ......... . .. x 10.00 . .................... ..... .. UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = U.LNSTgGS1 vvnv3-46N.v:CE•:::ry}j:}•i0v000.:.:..:.;:.8.:.vTU•:::.:..�..:.:... < a > < > • x100.00- - USED APPLIANCE<406,000.8-T6- . x 50.00 = r,.lva}vrynvm�v.�:wu..•rrirv:vw.vw.m i:.i/!.. :rr:ir:!:`;:ii:j�ii�:?� iii} :;!Y.•}:<^Y.. :!}}};}::;_: ��tf��� [�'{� A.PpItANG .... ..� 0.0>87iJ �> :::» : < : :;:<�> > >: x100.00 AIR HANDLER<10,000 CFM • 0 x 1200 = - :.v�tw 0 . ` ........:... x 15.00 SUBTOTAL $ 35 . 00 PLUS: PROCESSING FEE • + $ 25.00 NOTE: MINIMUM PERMIT FEE(S $35.00 EQUALS: TOTAL PERMIT FEE DUE _ $ 60 .00 SIGNATURE rnnLonn rsni..ilt/ fl;.,:,,:..... „I n..a.i:_