1992, 07-14 Permit App: 92005219 Mechanical Fixtures351aA• cOaNf
OCC---L10nl a5;?2, tt0
JOB STREET ADDRESS:
CITY/STATE/ZIP:
OWNER: Laney
MECHANICAL PERMIT APPLICATION FORM
Information Worksheet
:.7.13•81 £ r .ct,S c,C.
9 4 zit- PARCEL NUMBER:
PHONE NUMBER: 92z Si3 Y
oeIf
oa5a(c1
MAILING ADDRESS:
CONTRACTOR: Banner
CONTACT: RUSS LUNDE
(Street) (City/State)
Fnrnare & Fnel , Tnr'IICENSE NUMBER: BANNEFF378NT
PHONE NUMBER: 535-1711
Spokane, WA: 99202
MAILING ADDRESS: P.O. Box 4346
(Zip)
(Street)
(City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
..................................................
.WOODSTOVE/INSERT
GAS WATER HEATER
GAS EQUIP. MENT <100,00018TU(INCLUDES ';
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
ROILER/REFRIG 101-500M BTU
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 & AIRCONDITIONER 15'-30 TONS
HEAT PUMP & AIR CONDITIONER 30-50 TONS
HEAT PUMP & AIR CONDITIONER +50 SONS
VENTILATING FANS
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
ULINSTED GAS APPLIANCE>400,000 BTU
USED APPLIANCE <400,000 BTU
USED APPLIANCE>400,000BTU
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM)ii
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(Zip)
NUMBER
OF UNITS
X EACH
UNIT
= AMOUNT
x 10.00 =
x 25.00
x10.00 =
x12.00 =
x 15.00 =
x 1.00 =
x 12.00 =
x 20.00 =
x 25.00 =
x35.00 =
x 60.00
x 12.00 =
x 20.00 =
x 25.00 =
k 35.00 =
*60.00 =
x 10.00
x 10.00 =
*50.00 =•
x 10.00 d
X 10.00 =
X 10.00 =
x 10.00 =
x10.00 =
x 50.00 =
X100.00 =
*50.00 =
x100.00 a
X 12.00 =
x 15.00 a
1
/3-.-
,/;a.•
t
2-° •
SUBTOTAL
$ Z% a°
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_ $ `/9"
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675