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1992, 04-15 Permit App: 92002522 Heat Pump
(gid - MECHANICAL PERMIT APPLICATION FORM ld3 9©liL..-, '*information Worksheet (71D - JOB D " JOB STREET ADDRESS: 7 /2- ,o-t.4j au� CITY/STATE/ZIP: 7?21-r PARCEL NUMBER: OWNER: Llq•..)d. t-i/y/t PHONE NUMBER: 7Z 7 Ak. Z? MAILING ADDRESS: (Street) (City/State) (Zip) CONTRACTOR: Banner Furnace Fc Fuel , Inc.LICENSE NUMBER: BANNEFF378NT CONTACT: RUSS LUNDE PHONE NUMBER: 535-1711 MAILING ADDRESS: P.O. Box 4346 Spokane, WA. 99202 (Street) (City/State) (Zip) MECHANICAL WORKSHEET/FEE SCHEDULE NUMBER X EACH DESCRIPTION OF UNITS UNIT = AMOUNT ELECTRIC/DUCTWORK(SEPARATE SYSTEMS) x 10.00 = WOODSTOVEJINSERT; x 25.00 = GAS WATER HEATER x 10.00 = GAS EQUIPMENT<100,000 BTU (INCLUDES x 12.00 = GAS EQUIPMENT +100,000 BTU DUCTWORK) x 15.00 = GAS PIPING (EA OUTLET) x 1.00 = BOILER/REFRIG 1-100M BTU x 12.00 = BOILER/REFRIG101-500MI3TU x 20.00 = BOILER/REFRIG 501-1,000M BTU x 25.00 = BOILER/REFRIG 1,0001-1,750M BTU x 35.00 = BOILER/REFRIG +1,750M BTU x 60.00 = HEAT PUMP & AIR CONDITIONER 0-3 TONS / x 12.00 = /L b d HEAT PUMP & AIR CONDITIONER 3-15 TONS x 20.00 = HEAT PUMP & AIR CONDITIONER 15-30 TONS x 25.00 = HEAT PUMP &AIR CONDITIONER 30-50 TONS x 35.00 = HEAT PUMP & AIR CONDITIONER +50 TONS x 60.00 = VENTILATING FANS x 10.00 = EVAPORATIVE COOLERS x 10.00 = TYPE I HOOD (PER 12' OR 12' PTN. OF HOOD) x 50.00 = TYPE II HOOD x 10.00 = CLOTHES DRYER x 10.00 = RANGE x 10.00 = GAS LOG x 10.00 = MISCELLANEOUS (NOT COVERED ELSEWHERE x 10.00 = UNLISTED GAS APPLIANCE<400,000 BTU x 50.00 = ULINSTED GAS APPLIANCE>400,000 BTU x100.00 = USED APPLIANCE<400,000 BTU x 50.00 = USED APPLIANCE>400,000 BTU x100.00 = AIR HANDLER <10,000 CFM ^ x 12.00 = AIR HANDLER>10,000 CFM x 15.00 = SUBTOTAL $ i o• PLUS: PROCESSING FEE + $ 25.00 NOTE: MINIMUM PERMIT FEE IS $35.00 EQUALS: TOTAL PERMIT FEE DUE _ $ 3 7 o a SIGNATURE Spokane County Division of Buildings West 1303 Broadway Avenue Spokane, WA 99260 (509) 456-3675