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1989, 06-27 Permit App: 89001955 ACJOB STREET ADDRESS: MECHANICAL PERMIT APPLICATION FORM Information Worksheet /.3Y -?3 C Ocam✓Ai CITY/STATE/ZIP: CV 9.2 / (ca PARCEL NUMBER: OWNER: -J-eq C C>/9-2". PHONE NUMBER: ?-Z 8' 9/3 6 MAILING 'ADDRESS: ( 3 9 9 2 l k (Zip) CONTRACTOR: CONTACT: (Street) (City/State)' BANNER FURNACE E, FUEL RUSS LUNDE MAILING ADDRESS: P.O. BOX 4346 LICENSE NUMBER: BANNEFF378NT PHONE NUMBER: 535-1711 (Street) SPOKANE, WASHINGTON 99202 (City/State) MECHANICAL WORKSHEET/FEE SCHEDUT,P, NUMBER X EACH OF UNITS UNIT DESCRIPTION (Zip) = AMOUNT DUCTWORK SYSTEM WOODSTOVE/INSERT GAS WATER HEATER HEATING EQUIPMENT <100,000 BTU HEATING EQUIPMENT +100;000 BTU GAS PIPING (1 - 4 OUTLETS) GAS PIING (5 OR MORE. EACH:) REFRIG 1-100M BTU (NOT A/C OR HEAT PUMP) REFRIG 101-500M BTU REFRIG 501-1,000M BTU REFRIG 1,001-1,750M BTU REFRIG +1,750M BTU AIR CONDITIONER 0-3 TONS AIR CONDITIONER 3-15 TONS AIR CONDITIONER 15-30 TONS AIR CONDITIONER 30-50 TONS _ AIR CONDITIONER +50 TONS _ FANS HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & HEAT PUMP & VENTILATING EVAPORATIVE COOLERS TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) TYPE II HOOD CLOTHES DRYER RANGE GAS LOG MISCELLANEOUS (NOT COVERED ELSEWHERE)_ - UNLISTED GAS APPLIANCE <400,000 BTU_ - UNLISTED GAS APPLIANCE >400,000 BTU USED APPLIANCE <400,000 BTU USED APPLIANCE >400,000 BTU AIR HANDLER <10,000 CFM AIR HANDf,FR >10,000 CFM x$10.00 = x 25.00 = x 10.00 = x 12.00 = x 15.00 = x 4.00 x 1.00 = x 12.00 = x 20.00 = x 25.00 = x 35.00 = x 60.00 = x 12.00 = x 20.00 = 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 = x 12.00 = x 15.00 = o� NOTE: MINIMUM RERMIT FEE -r 71cj SIGNATURE $35.00 SUBTOTAL PLUS: PROCESSING FEE + $ 25.00 EQUALS: TOTAL PERMIT FEE DUE $ 37Q0 Spokane County Department of Building and Safety West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675