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1992, 08-25 Permit App: 92006845 Mechanical Fixtures • e ....._ . ,,Avo . c\---,, ,,,, ,r 6302 .$- 1-92 - -- - MECHANICAL PERMIT.APPLUCATION FORM - _ Information Worksheet '- - .JOB STREET ADORESS -{. : 5613 E 15th Street - r-:: .;: :�.-.:•:,- . -•. . ,,.� . - CITY/STATEWP: - SPok - wa - PARCEL NUMBER;• 1"- - : f o - •r '. OWNER: MR ..• ui' - . B'-_' PHONE NUMBER:-- (509) 934-'1921 - MAILING ADDRESS: - 5613 E. 15tk_S+- . (Street) - • (City/State) (TP) CONTRACTOR: -Sturm Heating, Inc-. - - UCENSENUMBER: STURMI* 210 QF • PHONE NUMBER: 325-4505 - E. 204 Indiana Spokane WA. 99207 - MAILING ADDRESS:, (Street) (City/State) .. (TSP) MECHANICAL WORKSHEET/FEESCHEDULE • - NUMBER X EACH • DESCRIPTION '- OF UNITS . UNIT =AMOUNT • ELEGTRIG DUCTWORK(SEPARATE SYSTEMS) x 10.00 = . ."C p taSfe ifff' .,... ����"�.��x��x�� - x 25.00 _GAs WATER HEATER . - - . x 10.00 = 10:00 - • "` Cl IP;t` - .•. C . EEE ..�- ;01•.U` `` 4::` ,1 x 12.00 = EQUIPM -4'i 00.000 8TU O_UCIWO.RK) x 15.00 = 12.00 - - l SAS IPI 0 •Q1:1T, 1) • ,4 ,131x..c::1, 2 x 1.00 = 2.00 BOItERIREFRIG 1-100M BTU x 12.00 = y. - ©IttERlRE :.Ya,6.4M" i"x , '..f..: moo_ r- x 20.00 =-- BOILERIREFRIG 501-1.000M BTU . . -.: ,:::-.. •_.. • x 25.00 .=.- ,�yy��{{yy i ��p X604>.1`` DM l ' f '- e'� x 35.00 - SOlafftt 1 :ti f. w:cwr n �Ar£.1. r�-�--'r 3 = • .. BOILERIREFRtG+1,750M BTU ' • x 60.00 =• •- MP N .° E 7 p i t C® .l�Il ©. .ERS!=. • 0 S� z%,; r ° x 12.00 = - HEAT PUMP&AIRC I TIONER3-15 TONS x20.00 = • ' •I EAX p .M gf ®N o( O ,E� gi t- 5 7Q7` x x 25.00 = - HEAT PUMP&AIR CONDITIONER 30-50 TOMS' • x 35.00 = • : ,.F�7.' Mp ;A ' CONI R014g-.+50'o _S`";<f °<r .. - x 60.00 = - - VENTILATING FANS x 10.00 = -f .n• 0 •8 3As11 ; O©.L�£RS�fi,,X4Warari.„.. f, 11-k . x-10.00 = - • TYPE I H000(PER 12'OR 12' Pm.OF HOOD) x 50.00 = -`PEitI_ii@Oc -4 _t ea - x 10.00 = CLOTHES DRYER. Si 10.00 = _w :zi z;4 > " .., - x 10.00 = GAS LOG x 10.00 = . ,'I 0..!t 1 .cU. .:t"O; ''©17;EREOLS N.eR „"': ••- 'x10.00 _ - UNLISTED GAS APPLIANCE<400.000 BTU ' x 50.00 = . .1STI fiNC0 ;000 83115re.41MM x100.00= • . USED APPt1ANC�E��<400,000 BTU x 50.00 = St tAfl,P f. ?. t. 00$'Lig-�;; . .. ?�tI; s c,ii, x700.00 - .. .. AIR HANDIER<10.000 CFM • ....... . x 1200 = • ,.,1R1EiAfl© z.<>«t;.<"'yt;'.�i:,<kitiigi ttev2 . . x15.00•_ SUBTOTAL• • $74_nn,�/�1 ��C� PLUS:PROCESSING FEE' ' +S 25.00' ' • NOTE: MINIMUM PERMIT FEE IS 535.00 EQUALS:TOTAL PERMIT FEE DUE =5 49.00 SIGNATURE__ _ --