1991, 07-03 Permit App: 91003962 Gas Piping3y Pit s
//CS f(2'J
MECHANICAL PERMR APPLICATION FORM
Information Worksheet
.SOB STREET ADDRESS: 13823 East 5TH Ct + S.okane Wa. 99216
CITY/STATEIZIP: Spokane, Wa. 99216
OWNER: Robert Hoover
PARCEL NUMBER: 2 / -18c/
PHONE NUMBER: 9 2 2-0 9 51
MAILING ADDRESS: Same
(Street)
CONTRACTOR: Sturm Heating, Inc.
MAILING ADDRESS: E • 204 Indiana
(City/State)
LICENSE NUMBER:
PHONE NUMBER:
Spokane
(Zip)
STURMI* 210 QF
WA. 99207
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVEIINSERT
GAS WATER HEATER
GAS(QU1PM>✓N ' • t �T1J ttNCL3D
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
...:....:::..
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 501-1,000M BTU
'BOILER. /.REFRIG.1,0001 1;750M :BTU
BOILER/REFRIG +1,750M BTU
HEAT PUMP & A(R CONDITIONER 0 3 TONS
HEAT PUMP &. AIR CONDITIONER 3-15 TONS
HEAT PUMP &AIR CONDITIONER 15 30. TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR CONDITIONER+50 TONS
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE( HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE 11 HOOD
CLOTHES DRYER.
RANGE<
GAS LOG
ISLE& ANEOUS (NOTCOVE EO ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APP1:IANCE>400000 BTU
USED APPLIANCE <400,000 BTU
i_SEO F PUANCE>4.0040t?0 . '
AIR HANDLER <10,000 CFM
AIR HANDLER >1 O Ot)(1 a
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE %i
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x10.00 =
-.
x12.00 =
x 15.00 =
1
x 1.00 =
1.0 0
x 12.00 =
x 20.00 =
._
x25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x 20.00 =
x25.00=
x 35.00 =-
x
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =
x 12.00 =
x 15.00 =
SUBTOTAL
$ 1.00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_$ 35.00
Spokane County Division of Buildings
West 1301 Rrnariwav Avn niin S nnkann u/A ow -ion /Gnf1 Ar