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1992, 07-17 Permit App: 92005693 Mechanical Fixtures
vEba4. IekeL 5 MECHANICAL PERMI•TAPPLICATION FORM . Information Worksheet JOB STREET ADDRESS:'•'!' 4118 S. Woodruff ..:.. ;,.':<':i; ,, .• :.:;,%..',: , . • CITY/STATE/0' • Spokane WA 99206 •PABCELNUMBER' ":• OWNER'. -. Bradley PHONE'NUMBER: 924-8307 9a- 5L0c3 #6171 3(0(0(49 7-17-92 MAILING ADDRESS' "G 4118 Woodruff (Street) -Sturm Heating, Inc.. CONTRACTOR: Spokane WA 99206 MAIUNG ADDRESS:- E. 204 Indiana DESCRIPTION • ELECTRIC/DU��yC'�(,�TWORK (SEPARATE SYS t LMS) 'rod .:.JCC' './ x�an»5;.�`✓%Fs`iw�'.. GAS WATER HEATEReolt- 4 -Cee } GAS EQUIPMENT+100,000 BTU DUCTWORK) Lam& = o TLan d Sia m +psi x ar-.• BOILER/REFRIG 1-100M BTU e % -" a , .'s' L (Citylstate) LICENSE NUMBER: PHONE NUMBER: Spokane (iP) STURNI* 210 QF 325-4505 • WA. 99207 • (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE BOILER/REFRIG 501-1,000M BTU . •. • .r . . Bo L RIR : RE BOILER/REFRIG +1; TU HEAT PUMP &AIR CONDITIONER 3-15 TONS 1' Fg7P :,M,�?' ,•. ian®NWPiT Old,. g.a0 ©.N$ ' HEAT PUMP & AIR CONDITIONER 30-50 TONS' :l1MP. • VENTILATING FANS UNUS 1 eL) GAS APPLIANCE <400,000 BTU 03130/N..1 „SIVE- Cyto}a0 USED APPLIANCE<400,000 BTU F liliP.PLYANCF�r ? 000 . AIR HANDLER <I0,000 CFMkger ' JUL 22 1992 NOTeSWI tJ nAFEWE IS S35.00 • SIGNATURE___ PP) NUMBER OF UNITS X EACH UNIT =AMOUNT x10.00 = X25.00 = . 1 x 10.00 = 510.00,• x12.00 = 1 x 15.00 = x 1.00 = x 12.00 = . x20.00 =•- x 25.00 ,_ .;. x35.00 =' x60.00 ='• x12.00= x 20.00 = x25.00 = x35.00 = x 60.00 = x 10.00 = x•10.00 = x 50.00 = x 10.00 = X 10.00 = $15.00 4 $4.00 • - x 10.00 = x 10.00 = X10.00 =-'•' x 50.00 = x100.00 = x50.00 = . . x100.00 = • .. x12.00 = x 15.00 = SUBTOTAL S 29.00 PLUS: PROCESSING FEE i +S 25.00' EQUALS: TOTAL PERMIT FEE DUE = S 54.00