1990, 06-06 Permit App: 90002555 Gas Log, PipingMECHANICAL PERMIT APPLICATION FORM
I n f crmat7ion``.Norksheet
JOB STREET ADDRESS: ,E ./ %/C CM rac-'
‘_6:5-51-2 0JJY
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So
CITY/STATE/ZIP: Siert
OWNER: L7.,)/1-4-1/hr-A.
MAILING ADDRESS:
CONTRACTOR:
G d e b s frg-C--
Stflrt.t
(Street)
BANNER FURNACE C; FUEL
PARCEL NUMBER:
PHONE NUMBER: 72y / 0 9
area .QR -'C U'A-
CON'T'ACT: RUSS LUNDE
MAILING ADDRESS: P.O. BOX 4346
(Street)
(City/State) (Zip)
LICENSE NUMBER:
BANNEFF378N'I'
PHONE NUMBER: 535-1711
SPOKANE, WASHINGTON 99202
(City/State) (Zip)
MECHANICAL WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
DESCRIPTION
= AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100;000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIVING (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
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
NEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
VENTILATING FANS
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12
TYPE II HOOD
CLOTHES DRYER
RANGE
0-3 TONS
3-15 TONS
15-30 TONS
30-50 TONS
+50 TONS
OR 12' PTN. OF HOOD)
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 HANDLER >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 =
/co.o.
NOTE: MINIMUM PERM T FEE IS $35.00
"' a \d,�
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
SIGNATURE
SUBTOTAL
PLUS: PROCESSING FEE
$ iy o 3
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_$2700