1990, 11-20 Permit App: 90006287 Gas PipingmLIMANIUAL rtttmI I ArrUUAii furl FUHM p5o63972.---
Information Worksheet
JOB STREET ADDRESS: N ISD I( , F
CITY/STATE/ZIP: S "ii.., PARCEL NUMBER:
OWNER: %"l• 72.S Ll /a- ^4& -Ton/
MAILING ADDRESS:
CONTRACTOR:
PHONE NUMBER:
(Street)
BANNER FURNACE & FUEL
CONTACT: RUSS LUNDE
)02._y 01z5)2--
(City/State)
LICENSE NUMBER:
BANNEFF378NT
(Zip)
PHONE NUMBER 535-1711
MAILING ADDRESS: P.O. BOX 4346
(Street)
MECHANICAL
DESCRIPTION
SPOKANE, WASHINGTON 99202
(City/State)
WORKSHEET/.FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
(Zip)
= AMOUNT
DUCTWORK SYSTEM
WOODSTOVE/INSERT
GAS WATER HEATER
HEATING EQUIPMENT <100,000 BTU
HEATING EQUIPMENT +100;000 BTU
GAS PIPING (1 - 4 OUTLETS)
GAS PIING (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
HEAT PUMP & AIR CONDITIONER
HEAT PUMP & AIR CONDITIONER
VENTILATING FANS
EVAPORATIVE COOLERS
0-3 TONS _
3-15 TONS _
15-30 TONS _
30-50 TONS _
+50 TONS
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_
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
7j/jP !l- 2
NOTE: MINIMUM PE T FEE I8 3 00
SIGNATURE 1'`
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675
SUBTOTAL
$
PLUS: PROCESSING FEE + $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 3S: