1991, 10-09 Permit App: 91006693 Gas Log, PipingMECHANICAL PERMIT APPLICATION FORM
Itttorrmatiort Worksheet
JOB STREET ADDRESS: `" -12_7 7 C e C '4
CITY/STATE/ZIP:7 9 z -o L , PARCEL NUMBER:
l
OWNER: pr'L'�<-- s. T PHONE NUMBER: 9 2-6, l/ 1
MAILING ADDRESS:
(Street) (City/State)
CONTRACTOR: Rinner Furnace & FLet, InC.LICENSE NUMBER: BANNEFF378NT
CONTACT: RUSS LUNDE PHONE NUMBER: 535-1711
MAILING ADDRESS: P.O. Box 4346 Spokane, WA. 99202
(Zip)
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
woods V !tt'S> nT
GAS WATER HEATER
GAS EQUIPMENT <100,000 BTU (INCLUDES
GAS EQUIPMENT +100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REFAIG .101.7,500M BTU
BOILER/REFRIG 501-1,000M BTU
Boit11171ittiliG 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. Fk JMf :«FAIR CONilitfO i' fi? TONS
VENTILATING FANS
EVAPORATIVE COOLERS ..
TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD)
TYPE II HOOD
CLOTHES DRYER
......................... .
RANGE
GAS LOG
MISCELLANEOUS (NOT COVi✓RED.ELSEWHERE;
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS,'APOL(l lv``E>4 , .#0.
USED APPLIANCE <400,000 BTU
USED APPLIANCE>400,000`STU
AIR HANDLER <10,000 CFM
AIR HANDLER>10,000
NOTE: MINIMUM PERMIT EEC` I$ S35.00
SIGNATURE
,c)-•
(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 =
/, va c
x 12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
J
x 60.00 =
x12.00 =
x 20.00 =
x 25.00 =
x 35.00 =
x 60.00 =
x 10.00 =
x 10.00 =
-J
x 50.00 =
x 10.00 =
x 10.00 =
x 10.00 =
x 10.00 =
fo. 0 0
x 10.00 =
x 50.00 =
x100.00 =
x50.00 =
x100.00 =
x 12.00 =
x 15.00 =
SUBTOTAL
$ / i -v"
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
_ $ 2C_oo
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675