1990, 10-25 Permit App: 90005676 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
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JOB STREET ADDRESS: S. 5011 Van Marter
CITY/STATE/ZIP: SpnkanP. Wa _ A92O6 PARCEL NUMBER:
OWNER: Mr. G. R. Hensley PHONE NUMBER: 926-8570
MAILING ADDRESS: SAME
(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 I
DESCRIPTION OF UNITS UNIT = AMOUNT
DUCTWORK SYSTEM x$10. 00 =
WOODSTOVE/INSERT x 25. 00 =
GAS WATER HEATER 1 x 10. 00 = 10 .00
HEATING EQUIPMENT <100, 000 BTU x 12.00 =
HEATING EQUIPMENT +100,000 BTU x 15. 00 =
GAS PIPING (1 - 4 OUTLETS) 1 x t OE? = 1 .00
GAS PIING (5 OR MORE. EACH: ) x 1. 00 =
REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12. 00 =
REFRIG 101-500M BTU x 20. 00 =
REFRIG 501-1,000M BTU x 25. 00 =
REFRIG 1,001-1,750M BTU x 35. 00 =
REFRIG +1,750M BTU x 60. 00 =
HEAT PUMP & AIR CONDITIONER 0-3 TONS _ _ x 12. 00 =
HEAT PUMP & AIR CONDITIONER 3-15 TONS _ x 20. 00 =
HEAT PUMP & AIR CONDITIONER 15-30 TONS _ x 25. 00 =
HEAT PUMP & AIR CONDITIONER 30-50 TONS _ x 35.00 =
HEAT 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 1 x 10. 00 = 10 .00
MISCELLANEOUS (NOT COVERED ELSEWHERE) _ x 10. 00 =
UNLISTED GAS APPLIANCE <400, 000 BTU_ _ _ x 50. 00 =
UNLISTED GAS APPLIANCE >400, 000 BTU_ _ _ x100. 00 =
USED APPLIANCE <400,000 BTU x 50. 00 =
USED APPLIANCE >400, 000 BTU x100. 00 =
AIR HANDLER <10, 000 CFM x 12 . 00 =
AIR HANDLER >10, 000 CFM x 15. 00 =
SUBTOTAL $21 .00
PLUS: PROCESSING FEE + $ 25. 00
EQUALS: TOTAL PERMIT-
NOTE: M NIMUM PERMIT FEE IS $35.00 FEE DUE _ $ 46. 00
SIGNATURE � .t-ctl (A--)At %
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675