1991, 08-22 Permit App: 91005215 Furnaces, PipingMECHANICAL PEFkMIT APPLICATION FORM
Information Worksheet
JOB STREET ADDRESS: ^ '7%p_ g, pt.4/ow/ cef CO/
CITY/STATE/ZIP: 7 22 0 6 PARCEL NUMBER:
OWNER: pm4.A.L 5 C r 7' PHONE NUMBER: i.ze 3 i/ 7
MAILING ADDRESS:
(Street) (City/State)
CONTRACTOR: Banner Furnace h Fuel, Inc LICENSE NUMBER: BANNEFF378NT
CONTACT: RUSS LUNDE PHONE NUMBER: 535-1711
MAILING ADDRESS: P.O. Box 4346
(Zip)
Spokane, WA. 99202
(Street) (City/State)
MECHANICAL WORKSHEET/FEE SCHEDULE
DESCRIPTION
ELECTRIC/DUCTWORK (SEPARATE SYSTEMS)
WOODSTOVE/INSERT:
GAS WATER HEATER
GAS-EQUIP,MENT<100,000BTU:(INCLUDES
GAS EQUIPMENT+100,000 BTU DUCTWORK)
GAS PIPING (EA OUTLET)
BOILER/REFRIG 1-100M BTU
BOILER/REERIG 101-500M STU.
BOILER/REFRIG 501-1,000M BTU
BOILER/REFRIG•110001-1,750M BTU
BOILER/REFRIG +1,750M BTU
HEAT PUMP B:AIR CONDITIONER 04 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 +50 TONS.. ` : •
VENTILATING FANS
EVAPORATIVE COOLER St_
TYPE! HOOD (PER 12' OR 12' PTN. OF HOOD)
.: ':; ' :::;.:...-:.
CLOTHES DRYER
GAS LOG
MISCELLANEOUS (NOT COVERED. ELSEWHERE
UNLISTED GAS APPLIANCE <400,000 BTU
ULINSTED GAS: APPLIANCE>400,000 BTU,,".`'
USED APPLIANCE <400,000 BTU
USED AP;P.LIANCE>400,000 BTU
AIR HANDLER <10,000 CFM
AIR HANDLER ;10,000 CFM
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
(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 =
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 =
2
oj'Xao
S
.S:O6
SUBTOTAL
$ A 9-.0o
+ $ 25.00
PLUS: PROCESSING FEE
EQUALS: TOTAL PERMIT
FEE DUE
= $ S T so
Spokane County Division of Buildings
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675