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1989, 09-11 Permit App: 89003299 AC MECHANICAL PERMIT APPLICATION FORM Information- Worksheet JOB STREET ADDRESS: E. 14108 16th CITY/STATE/ZIP: Spokane, Wa. 99216 PARCEL NUMBER: OWNER: Mr Bob Brown PHONE NUMBER: 922-7126 MAILING ADDRESS: SAME (Street) (City/State) (Zip) CONTRACTOR: Sturm Heating. Inc. LICENSE NUMBER:STURMI*210 QF PHONE NUMBER: 325-4505 MAILING ADDRESS: E. 204 Indiana Spokane , Wa. 99207 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT = AMOUNT DUCTWORK SYSTEM x$10. 00 = WOODSTOVE/INSERT x 25 . 00 = GAS WATER HEATER x 10 . 00 = HEATING EQUIPMENT <100, 000 BTU x 12 . 00 = HEATING EQUIPMENT +100, 000 BTU x 15. 00 = GAS PIPING (1 - 4 OUTLETS) x 4 . 00 = GAS PIING (5 OR MORE. EACH: ) x 1 . 00 = REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) x 12 . 00 = REFRIG 101-500M BTU x 20. 00 = REFRIG 501-1, 000M BTU x 25. 00 = REFRIG 1, 001-1,750M BTU x 35 . 00 = REFRIG +1,750M BTU x 60. 00 = HEAT PUMP & AIR CONDITIONER 0-3 TONS _ _ 1 x 12 . 00 = 12 .00 HEAT PUMP & AIR CONDITIONER 3-15 TONS x 20 . 00 = HEAT PUMP & AIR CONDITIONER 15-30 TONS _ x 25 . 00 = HEAT PUMP & AIR CONDITIONER 30-50 TONS _ x 35 . 00 = HEAT PUMP & AIR CONDITIONER +50 TONS _ _ x 60 . 00 = VENTILATING FANS x 10 . 00 = EVAPORATIVE COOLFRS x 10 . 00 = TYPE I HOOD (PER 12 ' OR 12 ' PTN. OF HOOD) x 50 . 00 = TYPE II HOOD x 10 . 00 = CLOTHES DRYER x 10. 00 = RANGE x 10 . 00 = GAS LOG x 10 . 00 = MISCELLANEOUS (NOT COVERED ELSEWHERE) _ x 10. 00 = UNLISTED GAS APPLIANCE <400, 000 BTU _ _ x 50 . 00 = UNLISTED GAS APPLIANCE >400, 000 BTU x100 . 00 = USED APPLIANCE <400, 000 BTU x 50 . 00 = USED APPLIANCE >400, 000 BTU x100 . 00 = AIR HANDLER <10, 000 CFM x 12 . 00 = AIR HANDLER >10, 000 CFM x 15 . 00 = SUBTOTAL $ 12 .00 PLUS: PROCESSING FEE + $ 25. 00 EQUALS: TOTAL PERMIT NOTE: M NIMUM PERMIT FEE IS $35. 00 FEE DUE = $ 37 . 00 SIGNATURE I lt Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675