1991, 03-14 Permit App 91001105 Heating Equip.3 .7--(is' o ao.
JOB STREET ADDRESS:
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
4235 S. = Driftwood Dr. .a09/
CITY/STATE/ZIP: Spokane, Wa. 99206 PARCEL NUMBER:
OWNER. Mr. & Mrs. Henry Eller PHONE NUMBER: 922-5785
MAILING ADDRESS: SAME
(Street)
CONTRACTOR: Sturm Heating, Inc.
MAILING ADDRESS: E. 204 Indiana
DESCRIPTION
(Street)
(City/State) (Zip)
LICENSE NUMBER: STURMI*210 QF
PHONE NUMBER: (509) 325-4505
Spokane, Wa.
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
DS•ro;uFlrISEI�T
:} r:v;>;::v.::::::':M1:'::::iv :J:i:'::J:l i:�:i}:}>}-ry m:?•i 4i}}}:pi
GAS WATER HEATER
>GAS EQUIPM T +0O 000 BTIJ INCLUDES<<<'r <',
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS::?PIPING' EA OUTL
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 501-1,000M BTU
•BOI )=#31R RIG>1 `0001-1 750M•
BOILER/REFRIG +1,750M BTU
HE I'PUMP::&AIR CONOITONER 0'-3•>T•
ONS<<.
HEAT PUMP & AIR CONDITIONER 3-15 TONS
I.EA>Pll,+4P<1iRGOND:ITiO.NER>::]5-30:40tIS>:<
Sm.-.:vxwxn,M-.vvnrvir?r-A..: r:. n....:v::x ............. r.. J}},•:::::nv::.L:v..0 :...:. n..
HEAT PUMP & AIR CONDITIONER 30-50 TONS
NHEA'T ..l3MP & i• • •••• ND1TJONER:+50 TONS
VENTILATINGFANS::::::...................:.v-:.-......................:................:
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
•
CLOTHES DRYER
GASLOG::.,h..:.,............:..:.:.........:........:...................h...............
MISCELLANEOUS:;(N:OCOVEREDELSEWHE R 1
:::::::::...::..:..:....:::..:::....:::.::.:.:................:...................:...:.....:..........:.::::.::.::.:::
UNLISTED GAS APPLIANCE <400,000 BTU
U.LINSX1rD GAS APPLIANCE >400 000 B
USED APPUANCE <400,000 BTU •
••
r.:r•.•iTwwiOBTI i•
AIR HANDLER <10,000 CFM
<AIR HANDL R 10 OQo:••
CFM
NOTE MINIMUM PERMIT FEE IS $35.00
SIGNATURE
99207
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
Y.:
1
x 12.00 =
12. 00
x 15.00 =
x1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 12.00 =
x20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 50.00 =
x100.00 =
x 50.00 =
x100.00 =•
1
1.00
x 12.00 =
x 15.00 =
SUBTOTAL
$13.00
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
=$38.00
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675