1991, 06-21 Permit App: 91003523 Mechanical Fixture t3G / 3
.
E
MECHANICAL PERMIT AEPLICATION FORM -
1 C o. tJ 1 ,for atiq 3orksheet .,..
y,
s, _ U )
JOB STREET'ADDRESS: east „�� • G� e i 7 � J
CITY/STATE/ZIP: Spokane , Wa . X9203 . I )I ti9 PARCEL NUMBER: /7_.55 - /,,c,__3
OWNER: Gary Fletcher PHONE NUMBER: 530794
MAILING ADDRESS: Same- L '-/-4,, (-1-1c. , -5
(Street) (City/State) (Zip)
CONTRACTOR: Sturm Heating, Inc. LICENSE NUMBER: STURMI* 210 QF
PHONE NUMBER:
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 = -
WOODSTOVE/INSERT x 25.00 =
.
GAS WATER HEATER x 10.00 =
GAS EQUI.PMI✓I ` eioo O O ;TU{INCLUDES 1 x 12.00 = 12. 0 0
GAS EQUIPMENT+100,000 BTU DUCTWORK) _ x 15.00
GAS:PIPING (EA OUTLET) ;; >1 x 1.00 =
BOILER/REFRIG 1-100M ETU x 12.00 = -
II LR/REE?1G 101-500M BTU
,... - - .... ..... ............. :.: x 20.00 = . .,.. _ .
BOILER/REFRIG 501-1,000M BTU x 25.00 = .
801LERJREFRIG X7',0001 1 i50M ETU ,j- x 35.00 =
BOILER/REFRIG +1,750M BTU
I. x 60.00 =
1
HEAT PUt�4P&AlR CONDI.. . 0-3 TONS x 12.00
HEAT PUMP &AIR CONDITIONER 3-15 TONS ; x 20.00 =
HEAT PUMP'-&AIR CONDITIONER 15-30 TONS j x 25.00 =
HEAT PUMP &AIR CONDITIONER 30-50 TONS { 1 x 35.00 =
};TEAT PUMP&AIR CONDITIONER +50:TONS x 60.00 =
VENTILATING FANS x 10.00 =
EVAPORATIVE COOLERS x 10.00 =
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
TYPE II HOOD x
>: 10.00 =
CLOTHES DRYER. x 10.00 =
:RANGE.... x 10.00 =
GAS LOG x 10.00 =
4tIS( CANEtJUS(NOT`COVERED>=LSEWHERE x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
_LJL1NSTED:GAS APPLIANCE}440,000 BTU { , x100.00 =
USED APPUANCE<400,000 BTU x 50.00 =
UttI < ANG
a,.:.,.., ..a.._.:....�,,.:..,,.,:....:.,..,..�....:,......:::::.:...::::.::-:_ x100.00 =
AIR HANDLER<10,000 CFM x 12.00 =
AIR »HANDLER 0400 CFM
;> x 15.00 =
SUBTOTAL $ 12 . 00
PLUS: PROCESSING FEE - + $ 25.00
NOTE: MINIMUM PERMIT FEE IS $35.00 EQUALS: TOTAL PERMIT
FEE DUE _$ 37 . 00
SIGNATURE _�1 t ( _i k '' �-� '\ti
I
Spokane County Division of Buildings