1991, 03-14 Permit App: 91001107 AC • /3- is i,,/
MECHANICAL PER, .1"APPLICATION FORM
Infor•: tionWorksheet
JOB STREET ADDRESS: 11721 4;;/pi je-4Pe...)
CITY/STATE/ZIP: Spokane, WA. 99206 PARCEL NUMBER:
OWNER: Mr. & Mrs . _Bruce Sprint PHONE NUMBER: 922-0821
MAILING ADDRESS: SAME ,22L?-5-(4$1--- 7
(Street) (City/State) �,� c./,p..,, /9<<^(Zip)
CONTRACTOR: Sturm Heating, Inc. LICENSE NUMBER: STURMI*210 QF
PHONE NUMBER: ( 509 ) 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
ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 =
i-W00C S' 'OVSI(1`CSS-..' ::::;:>::>::>: :-::;:. x 25.00 =
GAS WATER HEATER_ x 10.00 =
CAS QUI ENT 00,000STU(INCUJDES .-------. x 12.00 =
GAS EQUIPMENT+100,000 BTU DUCTWORK) x 15.00 =
GAS PIPING EA OUTL
x 1.00 =
BOILER/REFRIG 1-100M BTU x 12.00 =
Q ma I i lO IoM S' i1.--. ....:::>::>:.: >:::::: x 20.00 =
BOILER/REFRIG 501-1,000M BTU x 25.00 =
6O1LEFl/REFR1G 7,0001; 1,750M BTU::`>::;°'`:>:> ::: `' > ;.<'.:>:>< x 35.00 =
BOILER/REFRIG +1,750M BTU x 60.00 =
HEAT'PUMP&-AIR CONDITIONER 0 3 TONS `:: >I-= 1 F 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 ZIR CONDITIONER+50 TONS .: :::``; x 60.00 =
VENTILATING FANS x 10.00 =
:-;;-,_--: ORATIVE COOLERS x 10.00 =
TYPE I HOOD(PER 12' OR 12' PTN. OF HOOD) x 50.00 =
:: VIrHOo « .....:........>........ <«ER >> « < >N
x 10.00 =
CLOTHES DRYER
x 10.00 =
X10.00 =
GAS LOG x 10.00 =
MISCELLANEOUS (NOT COVERED ELSEWHERE x 10.00 =
UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 =
L-----STEO-CAS APPUANCE>400,000 STU -.; ;::;::;:::;. ;.;_.;<:.:;_:. x100.00=
USED APPLIANCE<400,000 BTU x 50.00 =
SED APP- ;.>NCE_::>4:: :;,00.::.::<>.; ._. . >_ ;> >'>< > > > >_ ><=<
U.: :,;;:_:.;;:.;;:.;;:.;�IANC(_. .COQ:13'TUx100.00=
•
AIR HANDLER<10,000 CFM x 12.00 =
AIR HANDLE X10,000 CFM < <' : '' `' x 15.00 =
SUBTOTAL $ 12 .00
PLUS: PROCESSING FEE +$ 25.00
NOTE: MINIMUM PERMIT FEE IS$35.00 EQUALS: TOTAL PERMIT
FEE DUE _$ 37 . 00
SIGNATURE.-. -
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675