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1992, 08-07 Permit App: 92006192 Mechanical Fixtures V _ -3(4)1 6215 _ . ::: . 7-30-92 -)6 MECHANICAL PERMIT APPLICATION FORM - Information Worksheet - •- ••- JOB STREET ADDRESS 4107 S Sunderland -•:':-‘1•••,..; • :. . ` CITY/STATE/ZIPL S okan wa , • • PARCEL NUMBER;t.•• • .. • ' • • '''''r•••• OWNER: - Q tant'ri i i e PHONE'NUMBER: MAILING ADDRESS: 4107 S Sunderland (Street) . . (City/State) (Zip) CONTRACTOR: Stu Heating, Inc. UCENSENUMBER: STURMI* 210 QF PHONE NUMBER: 325-4505 • - MAILING ADDRESS: E. 204 Indiana Spokane WA. 99207 • • • •(Street) (City/State) •• . (Zip) • MECHANICAL WORKSHEETIFEESCHEDULE - NUMBER X EACH DESCRIPTION .• OF UNITS UNIT =AMOUNT • • ELECTRIC/OUCTWO (SEPARATE SYSTEMS) x 10.00 = • • .n 6 o d5 •v1,.S>~ S, a; lefi >sMxMUx ,', . x 25.00 = - GAS WATER HEATER . - . . x 10.00 =ga 10:00 -. eatliP.M • , s :,0 G 8 41.,•.0 \ " a: 1 x 12.00 = - -12.0d EQUIPMENT Bill DUCTWORK) GAS , x 15.00 = - .GAS •IpiNG '0 WirA; Ari, :�:,4,x ,s., . .a. M r:2"' x 1.00 = BOILER/REFRIG 1-100M BTU x 1200 = . • • • • -- . • ` • 1-0 itIER/E3FRAO..Pr% a2ya��L'��RfY^�,�G!�ioe.7.'�::u"�^Z: x20.Q0 =. BOILER/REFRIG 501-"i.000M BTU . •.: :. • .- • x25 00 _ t•. soft RiFI Rt 1 oo 4R 4E� ., i T q .Altir,St4tax 35.00 = - - BOILER/REFRIG+1,750M BTU ' • x 60.00 = '• . EA7.,P,.MP :.'•.R G® •01;1:x® ER'0,;. . :0 S` zityx, x 12.00 = . HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = •- • -�r.r.• ri w WAD, EAC Ply M . A�R•COND1- 4®,E . •S.:W'W3'r`0.T•O`.5' x 25.00 = • HEAT PUMP&AIR CONDITIONER 30-50 TONS' x 35.00 = .x;-.I1MP :, . C©NDtil'.oNE'>+ 0" 0. '4'04 `> " x 60.00 = • VENTILATING FANS x 10.00 = • iSERgy �. Y• ,A E ®OLS£ . `- 24 .."-44.-. ';:a> € :a: x•10.00 = - TYPE I HOOD(PER 12' OR 12' PTN.OF HOOD) • _ x • 50.00 = peit.H®C�a ffaT -W l wou•t x 10.00 = CLOTHES DRYER. - x 10.00 • - , - . 'OEC: ,: x .„ -"ft x 10.00 = GAS LOG x10.00 = I:.•: . ; e4.. t OT'•yOVEI.ED.ELS.l i. Ei •e - _' - .- x10.00 . UNLISTED GAS APPLIANCE<400,000 BTU ` x 50.00 = :'LI. S EDiGA..cA1 P ACE „0�40 81 OacL xi . . USED ��APPpPUAAAK+NCEE<400,000 BTU x 50.00 = SC..I"J!1'.{'I�te41C • l r X1�ka-V4t.: 4,,,;j9'•••:14 • {/�/�/�/�• • J■ ^. ^'`i w. :y"G6".!•.t'n�.w: s`Y�":Fck`` '(iiN„i''.r+, X100.00 00.00 e• AIR HANDLER CI0.000 CFM ( • µ .• . . •x Z 200 _. . Cf','M?m?f.''',,Mie•.`'v,N^0<'�>l15.33,a_,..Lvia'y.'ro .„� .. 1RiH1i2.- -- a:.:.,::: U.�_Azrzu.�:s-�f�t;?,�.T,:yl - •. x 15.00= ' .. - • - SUBTOTAL . S 22.0Q • PLUS: PROCESSING FEE• ' +S 25.00: ' NOTE MINIMUM PERMIT FEE IS S35.00 EQUALS: TOTAL PERMIT FEE DUE -S47.u0 / SIGNATURE__ -- _ .-- - /