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1991, 08-01 Permit App: 91004677 Gas Piping, RangeMECHANICAL PE-FIMET Al3PLECATION FORM Infprrpglioji Worksheet JOB STREET ADDRESS: 1 823 Routh_ Fel -1-g Spokane 99206 CITY/STATE/Z1P:Spokane Wa- 9 9 2 0 6 PARCEL NUMBER: OWNER: Bud Oakes PHONE NUMBER: MAILING ADDRESS: (Street) CONTRACTOR- Sturm Heating, Inc_ MAILING ADDRESS: - 204 Indiana (Street) (City/State) MECHANICAL WORKSHEET/FEE SCHEDULE (City/State) . (Zip) LICENSE NUMBER: s u iRm * 210 QF PHONE NUMBER: Spokane WA A. 9 9 2 0 7 DESCRIPTION ELECTRIC/DyCZVIORK5SEPARATE SYSTEMS) la:0:076:10WILSaldeggiNKMIAgagiOiti:ii,1 GAS WATER HEATER '3 1i000OO STiJ7.77drek GAS EQUIPMENT E100,000 BTU DUCTWORK) BOILER/REFRIG 17100.M. BTU iffaiWEIROMMIG§PgRiPtu BOILER/REFRIG50171,000M BTU BOERIREFR.IG1 0001-1 750m RTU OTE: MINIMUM PERMIT FEE 1S 1;35.00 (Zip) SIGNAit)1;1 • 1 I OTAL PLUS: PROCESSING FEE EQUALS: TOTAL PERKSIT--- -- PEE DUE 4 s 25.00 . 0 NUMBER OF UNITS X EACH UNIT = AMOUNT ::igiginie x10.00 = x 25.00 = x10.00 = x 12.00 = x 15.00 = x 1.00 = x 12.00 = x20.00 = I x 25.00 = -- - - . 1 1.00 SIGNAit)1;1 • 1 I OTAL PLUS: PROCESSING FEE EQUALS: TOTAL PERKSIT--- -- PEE DUE 4 s 25.00 . 0