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1991, 10-09 Permit App: 91006717 Furnace, Piping
• 11 MECHANICAL PERMITAPP.LICATION FORM Information Worksheet JOB STREET ADDRESS: E. 13119 7th Ave. CITYISTATE/ZIP:Spokane, WA 99216 PARCEL NUMBER: 225ij/- /017 OWNER' Mr and Mrs Haqseth PHONE NUMBER: 926-7683 MAILING ADDRESS: E. 13119 7th Ave. Spokane, WA 99216 CONTRACTOR• (Street) (City/State) Sturm Heating, Inc. LICENSE NUMBER: MAILING ADDRESS: E. 204 Indiana (Street) DESCRIPTION (MP) STURMI* 210 OF PHONE NUMBER: 325-4505 Spokane WA. (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE ELECTRIC/DUCTWORK (SEPARATE SYSTEMS) U • GAS WATER HEATER' GAS EQUIPMENT +100,000 BTU DUCTWORK) GAS IPI :T. . • ..... ... BOILERIREFRIG 1-100M BTU BOILER/REFRIG 501-1,000M BTU . BOILER!REFRIG +1,750M BTU D ©ER Io HEAT PUMP & AIR CONDITIONER 3-15 TONS EA. .'1L P �'s .c 0l.DI: 1©.•E 1 5 OQ a7� HEAT PUMP &AIR CONDITIONER 30-50 TONS VENTILATING FANS tG®o ER TYPE 114000 (PER 12 OR 12PM!. OF I -100D) -E4 CLOTHES CLOTHES DRYER. GAS LOG SOEL'.NE© UNLISTED GAS APPLIANCE <400,000 BTU EWHREA USED APPUANCE.<400,000 OW AIR HANDLER <10,000 CFM !ASIS sER. T0? NOTE: MINIMUM PERMIT FEE IS $35.00 SIGNATURE okane C 99207 (LP) NUMBER OF UNITS XEACH UNIT =AMOUNT x10.00 = . x 25.00 = x10.00= -- 1 x12.00 = x15.00= 12 nn s 1 x 1.00 = x12.00 .--- x 20.00 x20.00 = x25.00= , x35.00 . x 60.00 = '• x 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 10.00 = x70.00 = 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 = 1.00 ..._ ... ..,--'&.. ... ,.._., ... . ., • ) .. ' . . SUBTOTAL $ 13.00 PLUS: PROCESSING FEE + $ 25.00' EQUALS: TOTAL PERMIT FEE DUE _$ 38.00 0...... t'.•..