1991, 07-05 Permit App: 91004006 Mechanical Fixtures MECHANICAL PERMIT APPLICATION FORM - • -
' Information Worksheet
JOB STREETADDRESS: South 3709 Woodruff
CITY/STATEIZIP: Spokane, Wa. 99216 PARCEL NUMBER: ..30,?.. / - o?D/e7
OWNER: Gilbert Mills PHQNE NUMBER: 926_-e9279
MAILING ADDRESS: Same 1J� + Z
(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 1 UNIT =AMOUNT
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) I x 10.00 =
1NOODSTOVI✓IINSER'I <: x 25.00 =
GAS WATER HEATER x 10.00 =
GABS_EQUIPM>=NT iO0i000(TU{INCWDES x 12.00 =
•GAS EQUIPMENT+100,000 8TU DUCTWORK) ; 1 x 15.00 = L 15 . 00
GAS P1PiNG(EA OUTLETj. j 1 x 1.00 = 1 .00 --
BOILER/REFRIG 1-100M BTU x 12.00 =
diS.ER/3 Ef R1G 101--500 M RTll x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
BOfLER/REFRIG 1,0001 1 750M ETU • x 35.00 =
BOILER/REFRIG +1,750M BTU ; x 60.00 -
r?EATPUMP&AIRCONDITIONER 0-3 TONS i x 12.00 --
HEAT
HEAT PUMP &AIR CONDITIONER 3-15 TONS
x 20.00 = fi
HEAT PUMP& 1.1 CONDITIONER 15 30 ONS
1 x25.00 =
HEAT PUMP &AIR CONDITIONER 30-50 TONS ( i x 35.00 =
HEAT PUMP&ASR CONDiT1ONER +50 TONS J x 60.00 =
VENTILATING FANS1 x 10.00 =
:EVAPORATIVE COOLERS ' x 10.00 =
TYPE 1 HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 =
TYPE II HOOD t x 10.00 =
CLOTHES DRYER. 1 x 10.00 =
RANGE : x 10.00 =
GAS LOG x 10.00 =
KS(SGI LLANEOUS#46ttOVi=RED ELSEWHERE ' ' x 10.00 = '
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 -
ULINSTED GASAPPLIANCE>400 000 8TU x100.00 =
USED APPUANCE<400,000 BTU x 50.00 =
PSE APPt.;1AN,GiwgiO00 BTU ''' x100.00 =
AIR HANDLER<10,660-64A x 12.00 =
4114 HAIJOLER».,000 CPM x 15.00 -
SUBTOTAL S 16 .00
PLUS: PROCESSING FEE + 5 25.00 ,
NOTE: MINIMUM PERMIT FEE IS $35.00 EQUALS: TOTAL PERMIT
_- FEE DUE - _ c-
---- 4 1 . 00_
SIGNATURE POLP.Ay'-- l
pokane County Division of Buildings