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1992, 08-14 Permit App: 92006450 Gas Log .. Service 8-12-92 MECHANICAL PERMITAPI?UCATiON FORM .` �' 'i information Worksheet • JOB STREET AODREJSS --! 6505 F. 11th - - -- - • . • • - - GI YlSTATE/ZIP' S_.kane Wa PARCEL NUMBER:.:- - OWNER= n F,�-Da - PHONE•NUMBER:'(-509) 536-5095 -- MAILING ADDRESS: 6505 E 11th Street) • (City/State) (Zp) CONTRACTOR 'Sturm Heating, Inc. - . UCENSENUMBER: STURMI* 210 QF . • PHONE NUMBER: 325-4505 • E. 204 Indiana Spokane WA. 99207 - MAILING ADDRESS: - •(Street) (City/State) (Zip) MECHANICAL WORKSHEEIIFEE SCHEDULE • NUMBER X EACH ' • OESGRIPT(OH OFUNtTS UNIt =AMOUNT • • ELECTRIC/DUCTWORK(SEPARATE SYS 1 LMS) x 10.00 _ • eiLs. erry4:f x25.00 GAS WATER HEATER . ' x 10.00 = ga .clIRM • t . bbE.3`17 <t °L.,'.0 laNsgi? X12.00 = . +100.000 BT(1 DUCTWOR x 15.00 = GAS EQUIPMENT .,,....,,.,.-_...___....� ...... . •GAS IPI ... - QIJT, 9 ,ww-4.;4. , :i .4,l>:43s .,z, x 1.00 = • M =. • BOILERIREFRtG 1-100M BTU x 1200 = . • ©It? ..-10.0-4V4'Mr``s' ,:• "T. is x20.00 - BOILERIREFRIG 501-1,000M BTU • •. •.: .;::•.. •_.. x 25.00 = t t ERF1fa1ad0 411.1`?,,�. OM,1;B x 35.00 = 80(�E� � - BOtLER/REFRtG-t-1,750M BTU ' • x 60.00 = • VIEAT P: MP '414 CO :D(Tj©- .ER-0,;.. ..,014s4maz° : x 1200 = - HEAT PUMP&AIR CONDITIONER 3-15 TONS r F T P T gz, ONDILOEtrf4•7(.5 .O, 5wla �r - • x 20.00 = x 25.00 = HEAT PUMP&AIR CONDITIONER 30-50 TONS' • x 35.00 = • • EAX.' MP t ONQIiTa.oNE' +50 0 S:.<g ag - x 60.00 - - • - VENTILATING FANS x 10.00 = - ���iSr--o��'�<r;�v-�CL kY..t,.. p�..��ryn f,�i I • aPDRfa7IVL 00L'* f3S S f�sr�ss -� ,%.-Ata-."... x•10.00 = TYPE I HOOD(PER 12' OR 12' FTN.OF HOOD) x 50.00 = ei'tI H®bi©, =.*. ''' ' :CAN;-14- • : - x 10.00 = CLOTHES DRYER. .. z 10.00 = GE• ° .�2iat.,N., `iaw.•�;. x ..v`cr' ';4 Z s2 x10.00 = GAS LOG • . 1 x10.00 = 10.00 t { ._Of, l'OTr",®, E• .ED; - --- i*. -z;-- x 10.00 _ - • UNLISTED GAS APPLIANCE<400.000 BTU ' x 50.00 = 81,:4-{ �s�r+� ,/�A�/�C � ♦,�j��S>p�♦�wf+y�.,`�C`.Y"�'r'"+'�";'•'�'!v' .1.1. J7-�Z V�f\'J`�..1 P. �l l V V L"♦•��1�V1/17N VI +Vw'�'t,:,Cie-�-v7.�v^'`c.:t�ii•ALwLSss, X100.00= . USED APPLIANCE<400,000 BTU x 50.00 - 'f�(�-'�f ( ANC •t}OOr$ •i.� �:, :'�.:�` `�;. ��N ;, x100.00=-- •'SfI M� M I'- . AIR HANDLER C10.000 CFM • «K3 X 1200 = _- --•- _ . 11_,..,>1(_L1 R « .. t}�fl{300�.CFM,> ;��t>�~>F,•=:K �.�.a�r��ui `�s�'�'�' �'���==f ••x 15.00• - • •-SUBTOTAL S 10-.-00 • PLUS: PROCESSING FEE ' +S 25.00: , NOTE MINIMUM PERMIT FEE IS S35.00 EQUALS:TOTAL PERMIT FEE DUE =S 35.00 SIGNATURE_, ---- - --- /