1992, 06-05 Permit App: 92004047 Heat PumpMECHANICAL PERMIT APPLICATION FORM
• Informat#on Worksheet �� a
JOB STREET ADDRESS: r::,7)154",','7.7- =Sa 7 ' £3,eA) 1-c__-7 /SCD
CITY/STATE/ZIP: % 2_ PARCEL NUMBER:
OWNER: 1Q6. 6ter A- K/"-,4vjo'"' PHONE NUMBER: `I ZY o$ IT
MAILING ADDRESS: -sem
(Street) (City/State)
CONTRACTOR: Rann r Furna P & Fue1_ Inc .LICENSE NUMBER: BANNEFF378NT
CONTACT: RUSS LUNDE PHONE NUMBER: 535-1711
MAILING ADDRESS: P.O. Box 4346 Spokane, WA.
DESCRIPTION
(Zip)
99202
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
W ODSTOVE/INSERT<
GAS WATER HEATER
GAS EQUIPMENT <100,000 RTU (INCLU( ES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG.101_S00NI ETl1
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG _1,0001-1 ,750M BTU:
BOILER/REFRIG +1,750M BTU
HEAT PUMP & AIR CONDITIONER 0=3 TONS
HEAT PUMP & AIR CONDITIONER 3-15 TONS
HEAT PUMP & AIR CONDITIONER 15-30 TONS:::>
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR CONDITIONER +50TONS'`<::>:;
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE
GAS LOG
MISCELLANEOUS (NOT COVEtIED ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS APPLIANCE:.>400,000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE >400,000`BTU:;:'::
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CPM. < `
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00 =
x 10.00 =
x 12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x12.00=
x 20.00 =
x 25.00 =
x 35.00 =
x60.00 =
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 =
-r;.
(
/1.-.r.4
x 12.00 =
x 15.00 =
SUBTOTAL
$ / z. ,--
,PLUS:
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_$ 37.0o
Spokane County bivision of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675