1990, 05-03 Permit App: 90001877 Heat Pump MECHANICAL PERMIT'APPLICATION FORM
information Worksheet
JOB STREET ADDRESS: E. 12814 Walton 036-/
CITY/STATE/ZIP: Spokane, Wa. 99216 PARCEL NUMBER: 0-5 5`t �
OWNER: Mr. R.L. Kennedy PHONE NUMBER: 924-4833
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
DESCRIPTION OF UNITS UNIT = AMOUNT
DUCTWORK SYSTEM x$10.00 =
WOODSTOVE/INSERT x 25. 00 =
GAS WATER HEATER x 10.00
HEATING EQUIPMENT <100, 000 BTU x 12 .00 =
HEATING EQUIPMENT +100, 000 BTU x 15. 00 =
GAS PIPING (1 - 4 OUTLETS) x ' , co =
GAS PIPING (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 _ _ 1 x 12 . 00 = 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 x 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 $ 12 . 00
PLUS: PROCESSING FEE + $ 25 . 00
EQUALS: TOTAL PERMIT}
NOTE: M N'IMUM PERMIT FEE IS $35. 00 FEE DUE = $37 . 00
SIGNATURE A
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Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675