1992, 12-10 Permit App: 92010854 Gas Log, Pipingas 1 D1
MECHANICAL PERM„ T APPLICATION FORM �UI
Information Worksheet
JOB STREET ADDRESS: _ 1::,, .ffi`r`.r'S � x9-09 D ti;C'C._
CITY/STATE/ZIP5 L/h Lti 969a042 PARCEL NUMBER:
OWNER: PC A + PHONE NUMBER:
MAILING ADDRESS: <5. Dish n'); C t& � j�L(n.� GJA- a 0
(Street) (City/State) • (Zip)
CONTRACTOR: RAnn'r Furnace & Fuel , Inc .LICENSE NUMBER: BANNEFF378NT
CONTACT: RUSS LUNDE
MAILING ADDRESS: P.O. Box 4346
PHONE NUMBER: 535-1711
Spokane, WA.
99202
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT'
GAS WATER HEATER
GAS;£QUIPM.ENT <100,000 BTU (INCLUDES--
GAS
INCLUDES ...GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)<w.':.:,,
BOILER/REFRIG 1-100M BTU
BOILER/REFRIG 101-500M BTU
BOILER/REFRIG 501-1,000M BTU
1101LER/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 o-50 TONS
VENTILATING FANS
....................................
EVAPORATIVE COOLERS
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
RANGE:tir%ti.
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 >400,000 Eau
AIR HANDLER <10,000 CFM
AIR HANDLER >10,000 CFM"''
NOTE: MINIMUM PERMIT FEE IS $35.00
(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 =
x20.00 =
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 =
1. b0
1
J O . CO
SUBTOTAL
$ 1 1, ® 0
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_ $ 30.00
SIGNATURE `L'`'{ JdAgs?»,.i.(.E-pcz x
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
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