1990, 09-07 Permit App: 90004436 ACJOB STREET ADDRESS:
CITY/STATE/ZIP:
PfitU;tIJ4FIIUML rtlilviui ArrLIbRIIUII runin
Information Worksheet
e, uc.o R�
PARCEL NUMBER:
/0 "
>I_435'- D/63
OWNER: g f% J Q � kt � �� PHONE NUMBER: 926 3 2 4 7
S fd. e,4SI AJ,4 9 9 2-/2--,
(City/State) (Zip)
CONTRACTOR: BANNER FURNACE $ FUEL LICENSE NUMBER: BANNEFF378NT
PHONE NUMBER: 535-1711
MAILING
ADDRESS:
.c /97r114L
(Street)
CONTACT:
RUSS LUNDE
MAILING ADDRESS: P.O. BOX 4346
(Street)
SPOKANE, WASHINGTON 99202
(City/State)
(Zip)
MECHANICAL
DESCRIPTION
WORKSHEET/FEE SCHEDULE
NUMBER X EACH
OF UNITS UNIT
= 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 &
HEAT PUMP &
HEAT PUMP &
HEAT PUMP &
VENTILATING
EVAPORATIVE
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
AIR CONDITIONER
FANS
0-3 TONS
3-15 TONS _
15-30 TONS ,
30-50 TONS _
+50 TONS
COOLERS
TYPE I HOOD (PER 12' OR 12'
TYPE II HOOD
CLOTHES DRYER
RANGE
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
1
,
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 =
/
NOTE: MINIMUM PERMIT FEE IS $35.00
SIGNATURE
is
SUBTOTAL
PLUS: PROCESSING FEE
+ $ 25.00
EQUALS: TOTAL PERMIT
FEE DUE
= $ 37.x°
Spokane County Department of Building and Safety
West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675