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1992, 02-04 Permit App: 92000605 Mechanical Fixtures l 0Z(P \3-I� \�� C -lQ(D5 R L13 ��', '' MECHANICAL PERMITAPPLICATION FORM ' rJ L4 a (`(\.`0% ( , ,\S In ?rmation Worksheet • - a i JOB STREET ADDRESS: f E. 5907 16th • CITY/STATE/ZIP: :.' -Spokane, WA 99212 PARCELNUMBER• OWNER: Miss Kathv Adams/Mr Arre PHONE NUMBER: 536-9524 MAILING ADDRESS: R. 5907 16th Ave. Spokane, WA 99212 (Street) (City/State) Pp) CONTRACTOR: Sturm Heating, Inc. LICENSE NUMBER: STURMI* 210 QF PHONE NUMBER: 325-4505 MAILING ADDRESS: E E. 204 Indiana Spokane WA. 99207 (Street) (City/State) (rip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT =AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = • c,; .Y•{+...ry:.,��. � ELECTRIC/DUCTWORK .`L�-':•ry}f4:erC`-�n'�::2345%_ tiki:??:nth"Y'.:!t+?:i<•Y w c sft : +N' k7 :'.,.}ry:h:.::Yri:::<: .>v::<<, = <,.� .<. <�..Mti{;<.YM,...v.::....H.Y..�.,rw,-..v.,�:Y.{w,}.<�t�� x 2s.00 GAS WATER HEATER . x 10.00 = - -- ::.'W --Qu P'. ..: .s'i ,.$` >,. ..:: 5:.. .; 1 _ x 12.00 = 12.00 _ GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 = ' GAP1.P(NC{�.��<; �.°tt{V::.<:«w%;::<:>}:�:%:;.;v<:<%«::<;::?:Y:«>�`m��, `;:: 1 x 1.00 = 1.00 BOILER/REFRIG 1-100M BTU x 12.00 = - . • • ,,,,y^,,.y«trM....,�.,,y. ,�,. y,}�.`',.,.,;;{.rt;}�:.;�::?f±a::?};�;+o:•wn:� :J ,„:� :' a.M.�, }u33�.hawwow%aw%,Q.w .:,:rt..:?rry<:x.:.<::{.:.:: = :., .-"-,-*-,: =;',:‘.1LIl>���1G ;,, '�`� ��::��?�:>:�:w>x```_:.,}>.:>.:}:::.:,..:�;Y{.:.},�� x 20.00 BOILER/REFRIG 501-1,000M BTU • .: _ . . x 25.00 = • I "- 000 ::7 :�0...,..r.. .n.:..,w::.�.,,,;{:�;ca.}x..•.;.:�};a}: ...:..... . .........,,..:................................... x35.00 = BOILER/REFRIG+1,750M BTU x 60.00 = . - • HEA'f{PUM $Mf R9.1DMO( ER 0 -3 TONS x 12.00 HEAT PUMP&AIR CONDITIONER 3-15 TONS x 20.00 = - • :}3.47x`PUMP'&.AIR:;GONDIT1ONER::1'S-3.O;TONS':<> >:> <_= ' }..,,��•:.�.,�,,,,,;..�},. .,,,,,�,�.<,,.,, ...�- :., , ,.:.:.....::........,.....: ,h x 25.00 =HEAT PUMP&AIR CONDITIONER 30-50 TONS' • x 35.00 = f-1kA' P1 eiF? �1 JR,CCANDITIONER+50 TONS _">_< ;t„ :;:; x 60.00 = ? { VENTILATING FANS x 10.00 = • y:n @Y^^Y�•m+vwY•+po- iF.;Y}vx{{^;{•v:nnv:::x:„y-n,}frnw. ':?:",�,"^";t'"'Y^ t.x c 3' ?,�i7�.��.�Y"�r:: 'y:%'-f+'>{:%::`:,•.;::;:_r:::� F;i:;yi3.tt�<::: ?.,xht-.v{•.,{vr.:vnA,x.}nWtadMdNAu QW1,Ci.vw,w{m,{kn{i'i:t:ii:GtJ:Ji..iii:C?4i::iiii?:t-L::i:::''`: ?}:i:: x 10.00 - TYPE I HOOD(PER 12' OR X1,2' PTN. OF HOOD) • x 50.00 = [41.0v.}•S}:y.Y. vry 4Si'::(.-•.{v:�ri4i{:.:f:?:i.:Xrr�:.v;i{..K'v}'i.?}:^:Y{{•i i:YMYA.;{nv: ..}<-..., ..>E--{.w::ii'<::{{.:.::�,..F,�: x 10.00 = , CLOTHES DRYER. x 10.00 = • a ric.:.v Y• :y4 ;RAG � - x1 = • ,.���k� � - >> 0.00 GAS LOG • - • x 10.00 = � v x10.00 °:.. ...?'"'#::;:.'s.770 ' '? f��`� C�3�V�EREI�:£L�E<+ti►�i✓f1��' : _ . . . .. , . c.�<iia,...,,..,::u•:{::,?:.::.xtw.:ai,;•::::•xe.{.,}�::v:c�t�: UNLISTED GAS APPLIANCE<400,000 BTU - x 50.00 = .,,;}•M W. f�Y'H.:^},},�•}•.N'�r4.n4p+.wwr-ryvt}�TY:Y:}:;}r,;r.}}xA+.. •�4% fiI-:1NSTa� NC 4(?OOU()f -ry..}� s;:>' �{# x100.00= . ;:,,A;Wi'1m-0.n �viAMivAv�+.�JfihTAv:i„ .v:Jn�i>}�J•.:{{:4i:�:<%i::`�Y.{%.�v' i� USED APPUANCE<400,000�, gBTU < x 50.00 •= SEI :P• y � < ,,irefi • x100.00=' AIR HANDLER<10,000 CFM • • x12.00 = S - `:,9' ?f'`-�Yryv�:f7�C,j,•i�-/,.n�My, >�.}.L6-• y'r•' • .... _: ... -._ .. AiR: 1NQ1R•� 1i:Q0()CI~M'; �>,.:;i.::a::...:>: •{..:z•A4 mit,} ry :<x}x x 15.00 r.__. MJ. a, .o<° ..•a..c.- ..c,S..c„ai�•...<ai'.cc%?�n:Ss::::•;:id„'N;-,:°''ri�ii::>.�,:�:?}ririi�2: xt = • • SUBTOTAL . $ 13.00 . PLUS: PROCESSING FEE• ' +$ 25.00: , NOTE MINIMUM PERMIT FEE IS$35.00 EQUALS:TOTAL PERMIT %" % . FEE DUE =$ 38.00 9 �y�f / SIGNATURE • i i !v� ' _ • / ' / Spokane County Division of Buildings